Danish pharmaceutical company Novo Nordisk has officially launched Awiqli, also known as insulin icodec, in India. This product is touted as the world’s first once-weekly basal insulin for adults diagnosed with Type 1 and Type 2 diabetes. This launch is considered a pivotal development in diabetes treatment, as it reduces the frequency of insulin injections from 365 per year to just 52.

Insulin serves a vital function in regulating glucose levels in the bloodstream by facilitating the uptake of sugar into cells, thereby preventing excessive accumulation. Individuals suffering from Type 1 diabetes and those with advanced Type 2 diabetes generally need to administer insulin either daily or several times a day to maintain optimal blood sugar levels.

Insulin administration in India has been historically delayed due to the patients’ fear of daily injections. Reportedly, this apprehension leads to a lag of approximately seven to nine years in insulin initiation for many individuals. This new product was developed specifically to counter this challenge and increase the acceptance of insulin therapy among patients.

Burden Of Diabetes In India

India is currently home to nearly 10.1 crore individuals living with diabetes, alongside an additional 13.6 crore people classified as prediabetic. Among these, over 9 lakh individuals are affected by Type 1 diabetes, an autoimmune disorder predominantly managed through insulin therapy. In addition, about ten per cent of those with Type 2 diabetes also require insulin treatment due to their bodies’ impaired ability to utilise insulin effectively.

Notably, four of the top five insulin brands in India, including Mixtard and Ryzodeg, are produced by Novo Nordisk. The company has also established a partnership with Abbott for the distribution of these insulin therapies across the country.

Awiqli differs from traditional basal insulins by requiring administration only once a week through a device referred to as FlexTouch. This approach is expected to enhance patient adherence to treatment and encourage those hesitant to start insulin therapy to do so at an earlier stage.

Importance Of Simplified Treatments

The introduction of Awiqli comes at a critical time as India faces one of the largest diabetes challenges globally. Recent data from the National Family Health Survey (NFHS)-6 has highlighted a notable increase in the prevalence of elevated blood sugar levels within both urban and rural demographics.

Clinical findings from the ONWARDS-1 programme have indicated that Awiqli achieves superior reductions in HbA1c levels, a key indicator of blood glucose control, compared to once-daily insulin glargine U100. This product has maintained a similar safety profile while demonstrating enhanced “time in range” for patients.

Vikrant Shrotriya, Managing Director of Novo Nordisk India, noted that the launch represents a significant milestone for diabetes care in the country, stating that the once-weekly regimen could effectively mitigate both psychological and physical challenges linked to insulin therapy.

Dr S.K. Wangnoo, an endocrinologist affiliated with Indraprastha Apollo Hospital in New Delhi, reiterated that delayed initiation of insulin treatment and poor adherence are persistent issues that compromise diabetes management outcomes. Innovations like Awiqli, which simplify treatment protocols, may encourage patients to start therapy more promptly.

Concerns around treatment adherence are prevalent among healthcare providers, while patients have often cited anxiety related to injections, pain, and complexity as reasons for postponing insulin use. The newly launched weekly option could serve as a bridge to address these longstanding barriers in diabetes care.

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