Once-Weekly Insulin for Type 2 Diabetes: Is Awiqli Right for You? (2026)
- Posted by Video-MD Editorial Team
- Published on May 29, 2026
- Category Benefit
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For decades, managing type 2 diabetes with insulin meant one thing—daily injections. Every single day, 365 times a year.
That’s no longer the only option.
In March 2026, the U.S. FDA approved insulin icodec (Awiqli)—the world’s first once-weekly basal insulin for adults with Type 2 diabetes. For millions of patients who struggle with daily injection routines, this is a genuinely life-changing development.
But is it right for you? In this guide, a Video MD physician explains exactly what once-weekly insulin is, who it’s designed for, and how to find out if you’re a candidate.
Want to know if Awiqli is right for your situation? Book an online diabetes consultation with a Video MD doctor — get expert advice today.
What Is Awiqli (Insulin Icodec)?
Awiqli (insulin icodec-abae) is a once-weekly basal insulin for adults with type 2 diabetes, used alongside diet and exercise to improve blood sugar control. As a long-acting insulin and an alternative to daily basal insulin, Awiqli reduces injections from seven times a week to just once weekly.
Awiqli is injected under the skin once a week on the same day each week using the FlexTouch pen.
It is manufactured by Novo Nordisk — the same company behind Ozempic and Wegovy — and represents a major leap forward in simplifying diabetes management.
Why Is Once-Weekly Insulin Such a Big Deal?
A big barrier to insulin use has always been the frequency of injections. Weekly insulin may help overcome the initial hesitation people have about starting insulin—and will greatly help patients who miss doses. With daily insulins, a missed dose causes hyperglycemia and glucose variability. This is much less likely with weekly insulin, even if it’s occasionally a day or two late.
About one-third of daily insulin-treated patients do not adhere to their therapy — making a once-weekly formulation a significant practical improvement for long-term diabetes management.
How Does Once-Weekly Insulin Work?
Insulin icodec is an analog of human insulin with three substitutions to its amino acid structure and an attached fatty diacid chain that allows the molecule to bind reversibly to albumin—prolonging its half-life to approximately 196 hours (around 7 days) and achieving steady state after just 3–4 once-weekly injections.
In simple terms: the molecule is engineered to release slowly and consistently over an entire week—mimicking what a healthy pancreas does naturally with basal (background) insulin.
Who Is Awiqli Approved For?
Awiqli is approved as an adjunct to diet and exercise to improve glycemic control in adults living with Type 2 diabetes.
You may be a good candidate if you:
- Have Type 2 diabetes requiring basal insulin
- Currently take daily insulin (Lantus, Toujeo, Tresiba) and struggle with adherence
- Are newly starting insulin and want the simplest possible routine
- Have a busy lifestyle that makes daily injections difficult
- Receive caregiver assistance — reducing to one injection per week is significantly easier
Important: Awiqli is currently approved only for adults with Type 2 diabetes. An FDA advisory panel expressed no safety concerns about its use in T2D, though concerns about hypoglycemia risk in Type 1 diabetes led to that indication being excluded from the approval.
Clinical Trial Results — Does It Actually Work?
Yes — the evidence is strong. In clinical trials under the ONWARDS phase 3a program, Awiqli improved HbA1c in adults with Type 2 diabetes and showed a safety profile generally consistent with daily basal insulin.
The ONWARDS trial program comprised five randomized, active-controlled, treat-to-target clinical trials in approximately 4,000 adults with type 2 diabetes—consistently showing robust clinical evidence across the full regulatory review.
Glycated hemoglobin (HbA1c) reduction was superior for icodec among insulin-naïve participants, and patients switching from daily basal insulin demonstrated improved diabetes treatment satisfaction scores with insulin icodec.
What Are the Side Effects of Awiqli?
Awiqli’s side effects are broadly consistent with other basal insulins. The main one to be aware of is hypoglycemia (low blood sugar).
Rates of clinically significant or severe hypoglycemia events were slightly higher with icodec compared to daily glargine in some trial arms — an important consideration your doctor will factor into your individual treatment plan.
Other standard insulin side effects include:
- Injection site reactions
- Weight gain
- Swelling in hands or feet
Your Video-MD doctor will monitor your response carefully, especially in the first few weeks of starting Awiqli.
When Will Awiqli Be Available?
Novo Nordisk plans to launch Awiqli nationwide in the U.S. in the second half of 2026. The product is already approved in the EU and 13 other countries, including Canada, Australia, and Japan.
If you’re outside the U.S., speak to a Video-MD doctor about whether Awiqli is currently available in your region.
Can an Online Doctor Prescribe Once-Weekly Insulin?
Yes. A licensed Video-MD physician can
- Assess whether you’re an appropriate candidate for Awiqli
- Review your current insulin regimen and HbA1c levels
- Transition you from daily to weekly insulin safely
- Monitor your blood sugar response via follow-up consultations
- Adjust your dose as needed over the coming weeks
Can an Online Doctor Prescribe Ozempic? — If insulin isn’t the right fit, a GLP-1 medication like Ozempic may be an alternative worth exploring with your doctor.
Awiqli and Other Diabetes Medications — Can You Combine Them?
In clinical trials, Awiqli was studied in combination with mealtime insulin and with common oral antidiabetic medicines and/or GLP-1 receptor agonists—meaning it can work alongside medications many Type 2 diabetes patients already take.
Commonly combined with:
- Metformin — standard combination
- GLP-1 agonists (Ozempic, Trulicity) — studied together in trials
- SGLT2 inhibitors (Jardiance) — compatible under medical supervision
- Mealtime insulin — for patients requiring full insulin coverage
Low Carb vs Low Fat Diet for Diabetics — Starting Awiqli? Your diet still matters. Read our doctor’s guide to the best eating approach alongside insulin therapy.
Questions to Ask Your Doctor Before Starting Awiqli
Before your consultation, it helps to prepare these key questions:
- Is my current HbA1c level a candidate for once-weekly insulin?
- Should I switch from my current daily insulin to Awiqli?
- How do I handle a missed weekly dose?
- Will my current oral medications or GLP-1 drugs interact with Awiqli?
- How do I adjust the dose if my blood sugar runs high or low?
- What should I watch for in the first month of treatment?
Frequently Asked Questions
What is Awiqli?
Awiqli (insulin icodec-abae) is the world’s first and only once-weekly basal insulin, FDA-approved in March 2026 for adults with type 2 diabetes to improve blood sugar control alongside diet and exercise.
Is once-weekly insulin as effective as daily insulin?
Yes. Clinical trials across approximately 4,000 patients showed once-weekly Awiqli achieved HbA1c reductions that were noninferior—and in some cases superior—to daily basal insulin.
Can I switch from my current insulin to Awiqli?
Potentially yes — but only under medical supervision. Your doctor will calculate the correct starting dose based on your current insulin regimen and monitor your transition carefully.
Is Awiqli available outside the U.S.?
Yes—Awiqli is already approved in the EU and 13 other countries, including Canada, Australia, and Japan. Speak to a Video MD doctor about availability in your region.
Does Awiqli cause low blood sugar?
There is a slightly elevated risk of hypoglycemia compared to some daily insulins in certain patient groups. Your Video-MD doctor will discuss how to monitor and manage this risk.
Can an online doctor prescribe Awiqli?
Yes. A licensed Video-MD physician can assess your eligibility, issue a prescription, and provide ongoing monitoring—all via a secure video consultation.
The Bottom Line
Once-weekly insulin is one of the most significant advances in diabetes care in years. For patients who have struggled with daily injection routines, missed doses, or injection fatigue, Awiqli offers a genuinely simpler path to blood sugar control.
The key question isn’t whether it works — the clinical trials confirm it does. The question is whether it’s right for you specifically — and that requires a conversation with a licensed doctor who knows your full health picture.
Book your online diabetes consultation today—a video-MD doctor will assess whether Awiqli is the right next step for your diabetes management.
Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
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