India has become the seventh country in the world to commercially launch Awiqli (insulin icodec), the world’s first once-a-week basal insulin approved for clinical use, marking a significant milestone in diabetes treatment.
Developed by Danish pharmaceutical company Novo Nordisk, the therapy replaces the need for daily basal insulin injections with a single weekly dose while delivering blood sugar control comparable to, and in some cases better than, existing once-daily basal insulin treatments.
The launch comes at a crucial time for India, where more than 101 million people are living with diabetes and another 136 million are estimated to have prediabetes, making the country one of the world’s largest diabetes hotspots.
According to the company, reducing injections from 365 to just 52 a year could help overcome psychological and practical barriers that prevent many patients from starting or continuing insulin therapy. The medicine is intended for adults with both Type 1 and Type 2 diabetes, although treatment plans differ depending on the condition and must be prescribed by healthcare professionals.
Novo Nordisk India Managing Director Vikrant Shrotriya said the company hopes the innovation will make insulin therapy less intimidating for patients and improve long-term treatment adherence.
While healthcare experts have welcomed the breakthrough as an important advancement, they also stress that Awiqli is not suitable for everyone and should only be used under medical supervision.
A Weekly Alternative Emerges
For decades, basal insulin therapy has required patients to administer injections every day to maintain stable blood sugar levels. Awiqli introduces a different approach through its active ingredient, insulin icodec, a long-acting insulin engineered to remain active in the body for an entire week.
The insulin binds to albumin, a naturally occurring blood protein, allowing it to be released slowly into the bloodstream over seven days. Patients inject the medicine once a week using a pre-filled pen into the abdomen, thigh or upper arm, with dosage tailored according to individual blood glucose levels.
For people with Type 1 diabetes, Awiqli replaces only the background insulin component and must still be used alongside rapid-acting insulin at mealtimes. Those with Type 2 diabetes may use it alone or alongside other diabetes medications, including rapid-acting insulin where clinically necessary.
The launch carries particular significance in India because insulin initiation is often delayed despite rising diabetes prevalence. Novo Nordisk says many Indian patients postpone insulin therapy by seven to nine years, largely due to fear of injections, treatment fatigue, social stigma and concerns about managing a daily injection schedule.
Clinical studies of insulin icodec found that once-weekly dosing achieved blood sugar control comparable to, and in some patient groups better than, existing once-daily basal insulin therapies while maintaining an acceptable safety profile.
Speaking on the launch, Vikrant Shrotriya, Managing Director of Novo Nordisk India, said the company hopes Awiqli will help remove both the psychological and physical barriers associated with insulin therapy and encourage more patients to begin treatment earlier and remain consistent with it.
The medicine has been priced at ₹2,611 for a 1 ml pen (700 units) and ₹7,833 for a 3 ml pen (2,100 units), with actual treatment costs depending on a patient’s prescribed dosage.
Growing Diabetes Burden Drives Innovation
India’s introduction of Awiqli comes amid an expanding diabetes crisis and a rapidly growing insulin market. According to Reuters, around 6 million Indians currently use insulin, a figure expected to increase to nearly 9 million in the coming years as diagnosis rates improve and the disease burden continues to rise.
Market research firm IMARC estimates that India’s insulin market will grow from US$660.5 million in 2025 to approximately US$916.4 million by 2034, driven by increasing diabetes prevalence, ageing populations, improved healthcare access and changing lifestyles.
Sedentary habits, unhealthy diets, obesity and genetic predisposition have all contributed to India’s growing burden of diabetes, making innovations that improve treatment adherence increasingly important.
Globally, Awiqli has already secured approvals in the United States, the European Union, Australia, Switzerland, Japan and several other countries before its Indian launch. The therapy now enters a competitive domestic insulin market that includes established daily basal insulin products such as Sanofi’s Lantus and insulin glargine brands manufactured by Biocon, Eris Lifesciences and Lupin.
Healthcare professionals have broadly welcomed the introduction of a once-weekly basal insulin as one of the most significant advances in insulin therapy in recent years, particularly for patients who struggle with daily injections.
At the same time, clinicians caution that the medicine is not a universal replacement for all insulin regimens. Doctors will continue to determine whether patients are suitable candidates based on factors including diabetes type, existing treatment, blood sugar control, lifestyle and the risk of hypoglycaemia. Experts also emphasise that patients should never switch insulin therapies without consulting their treating physician.
The Logical Indian’s Perspective
India’s launch of the world’s first once-a-week basal insulin is a reminder that healthcare innovation is meaningful only when it improves people’s everyday lives. For millions living with diabetes, treatment is not simply about medicines but about navigating fear, fatigue, affordability and the emotional burden of managing a lifelong condition. By reducing the frequency of injections, Awiqli has the potential to make insulin therapy less daunting and improve treatment adherence for many patients.
However, scientific breakthroughs alone cannot solve India’s diabetes challenge. Greater public awareness, affordable access to medicines, early diagnosis, healthier lifestyles and equitable healthcare services remain equally essential to reducing the disease burden. Innovations such as Awiqli should therefore be viewed as part of a broader effort to make chronic disease management more compassionate, accessible and patient-centred, rather than as a standalone solution.
