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NEW DELHI — In a development that could fundamentally reshape diabetes management for millions, Novo Nordisk officially launched Awiqli (insulin icodec) in India this week. The medication, recognized as the world’s first once-weekly basal (long-acting) insulin, aims to slash the annual injection burden for adults living with diabetes from 365 doses to just 52.
For India, a country currently grappling with one of the world’s largest diabetes burdens—with over 101 million adults living with the condition and 136 million more classified as prediabetic—the arrival of Awiqli is seen as a potential turning point in addressing long-standing hurdles to care.
A New Approach to Insulin Therapy
Insulin has been the cornerstone of diabetes treatment for over a century, yet “insulin inertia”—the delay in starting necessary insulin therapy—remains a pervasive problem. Clinical data from the International Diabetes Federation suggests that insulin initiation in India is often delayed by seven to nine years.
“Innovations that meaningfully simplify the treatment experience have the potential to change patient behavior,” says Dr. S.K. Wangnoo, Senior Consultant Endocrinologist and Diabetologist at the Apollo Centre for Obesity, Diabetes & Endocrinology, Indraprastha Apollo Hospitals, New Delhi. “A once-weekly basal insulin could reduce the apprehension around starting insulin and help clinicians have more productive conversations about timely treatment.”
The psychological and physical weight of a daily injection routine is a primary driver of non-adherence. By shifting the requirement to a single weekly injection, Novo Nordisk aims to reduce these barriers, moving from a daily reminder of the condition to a more manageable, long-acting regimen.
What the Evidence Shows
The rollout follows a rigorous global phase 3 clinical program known as ONWARDS. These trials evaluated the safety and efficacy of insulin icodec across diverse populations, including participants in India.
The clinical findings indicate that Awiqli provides glycemic control comparable to—and in some trials, superior to—once-daily insulin glargine. Key metrics from the trials include:
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HbA1c Reduction: Patients achieved significant reductions in their long-term blood sugar markers.
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Time in Range: Data showed improvements in the percentage of time patients spent within their target blood glucose range throughout the day.
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Safety Profile: The overall safety profile was reported as comparable to current once-daily basal insulins.
Important Safety Considerations
While the convenience of weekly dosing is a significant advancement, experts emphasize that this is not simply “daily insulin with a new schedule.” Insulin icodec is a novel ultra-long-acting formulation that requires specific clinical handling.
“Hypoglycemia (low blood sugar) remains the most common adverse reaction associated with insulin therapy, and this holds true for Awiqli,” notes the company in its clinical briefings. Because of its prolonged half-life, clinical guidelines emphasize that patients cannot switch to Awiqli without medical oversight. The transition from a daily insulin routine involves careful dose calculations to ensure blood glucose levels remain stable.
Furthermore, the medication is not currently indicated for pediatric use and requires careful management in patients with renal (kidney) complications. Clinicians also stress that Awiqli should never be mixed with other insulins or used in insulin pumps.
Practical Implications for Patients
For the estimated 6 million Indians currently on insulin therapy, the launch of Awiqli offers a glimpse into a less intrusive future. However, healthcare professionals caution that patients should not attempt to switch treatments independently.
“The main takeaway for patients is that this is a prescription therapy that necessitates structured follow-up,” explains Dr. Wangnoo. “Particularly during the initial switch from a daily regimen, close glucose monitoring is essential to ensure a smooth transition.”
The drug is being introduced with a pricing structure intended to compete with existing basal insulin options, with a weekly dose of 70 units priced at approximately ₹261.
Looking Ahead
As the medical community integrates this once-weekly option into routine practice, the focus will be on patient education. Because the dosing is less frequent, the impact of a potential medication error—such as missing a dose or accidental double-dosing—carries a different level of risk than it does with a daily routine.
The introduction of Awiqli marks the seventh country where the therapy has been launched, signaling a major shift in how the global pharmaceutical industry is addressing the “injection fatigue” that has long plagued chronic disease management. For the millions in India working to manage their blood sugar, this development represents not just a reduction in needles, but a potential improvement in the quality of their daily lives.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
References
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The Hindu (2026). “Novo Nordisk launches weekly insulin shot Awiqli in India,” published July 9, 2026.
