Many people with type 2 diabetes have built their day around an insulin shot.
It becomes a routine, but also a daily reminder of the condition. For some, that routine could soon look very different.
The US Food and Drug Administration has approved Onswik (insulin efsitora alfa), a once-weekly basal insulin from Eli Lilly for adults with type 2 diabetes.
The approval was announced on September 24, 2026, HCPLive reports.
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The math is simple. On daily basal insulin, a patient takes 365 shots a year. On a weekly injection, that drops to 52.
Onswik is the second long-acting weekly insulin to clear the FDA. The first, Novo Nordisk's Awiqli (insulin icodec), was approved earlier in 2026.
How the once-weekly insulin was tested
FDA approval rested on four phase 3 trials known as QWINT-1 through QWINT-4. More than 3,400 adults with type 2 diabetes took part.
The studies compared the weekly shot against the standard daily basal insulins glargine and degludec in different patient groups.
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The groups included people new to insulin, people already on a daily basal insulin, and people on a more intense basal-bolus regimen.
In each group, the weekly shot lowered long-term blood sugar by about the same amount as the daily shot.
A meta-analysis published in Endocrinology, Diabetes & Metabolism in October 2025 pooled six randomized trials with 3,967 adults.
It found no significant difference in blood sugar control between the weekly and daily insulin.
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Rates of hypoglycemia, meaning episodes of low blood sugar, were also similar. That held true for severe episodes as well as milder ones.
Who the new insulin is for and who should avoid it
Onswik is approved only for adults with type 2 diabetes. The FDA cautioned against using it in people with type 1 diabetes, where the larger weekly dose carries a higher risk of severe low blood sugar.
The label also flags a risk of low potassium levels. It warns of heart failure in patients who combine the drug with a group of diabetes pills called thiazolidinediones, which includes pioglitazone.
More than 40 million Americans have diabetes, according to the CDC.
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Type 2 accounts for about 90 to 95 percent of cases, and some of those patients add insulin when pills and lifestyle changes are no longer enough.
Anyone considering switching from a daily to a weekly shot should talk with their doctor.
Dose adjustments, meal timing, and how low blood sugar is handled may all change with a weekly drug.
The starting dose for people new to insulin is 100 units once a week, with step-ups every four weeks to a maximum of 400 units per shot.
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Eli Lilly plans to launch Onswik in the United States in the coming months in two prefilled pens.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.