Hundreds of thousands of people living with type 2 diabetes in England could soon replace daily insulin injections with a once-weekly treatment following a recommendation from the National Institute for Health and Care Excellence.
The proposed move could reduce the number of insulin injections required by up to 85%, offering significant benefits for patients, carers and healthcare services alike.
The treatment, insulin efsitora alfa, marketed as Onswik and developed by Eli Lilly, has been recommended in final draft guidance from NICE after evidence showed it delivers comparable blood glucose control to established daily long-acting insulin therapies.
For people who rely on assistance to administer insulin, the introduction of a weekly injection could have a substantial impact on their quality of life.
Individuals with sight loss, reduced dexterity, learning disabilities, frailty or difficulties managing complex medication routines may benefit most from the reduced treatment burden. Fewer injections could also mean fewer visits from carers or healthcare professionals, helping people maintain greater independence.
Healthcare leaders are also likely to welcome the potential reduction in community care demands and administration costs associated with daily insulin support.
Clinical trial data reviewed by NICE found that insulin efsitora alfa provides blood glucose control equivalent to two of the most widely prescribed long-acting insulins currently used in type 2 diabetes care: insulin degludec and insulin glargine.
This means patients switching from daily insulin can expect similar clinical outcomes while significantly reducing the frequency of injections.
The weekly treatment can be prescribed either as a standalone insulin therapy or alongside other medicines used to manage type 2 diabetes.
The new option could also help improve treatment adherence among patients who find it challenging to maintain a daily injection schedule.
NICE highlighted a potential benefit for younger adults diagnosed with early-onset type 2 diabetes, particularly those under the age of 40 who are balancing intensive diabetes management with employment and family commitments.
By simplifying treatment regimens, healthcare professionals may be able to support better long-term engagement with insulin therapy.
Helen Knight, Director of Medicines Evaluation at NICE, said:
“Moving from daily injections to a single weekly dose could make a real difference to the day-to-day lives of people with type 2 diabetes, especially those who rely on a carer, family member or healthcare professional to help them inject.
“This recommendation is the result of rigorous, evidence-based decision making, striking a balance between the benefits to patients and the best use of limited NHS funding."
Type 2 diabetes remains one of the UK's most prevalent long-term health conditions. The disease develops when the body either does not produce enough insulin or becomes resistant to its effects, resulting in elevated blood glucose levels.
According to the latest figures, 4.6 million people in the UK were living with diagnosed diabetes in 2023-24, with around 90% of cases classified as type 2 diabetes.
With demand on diabetes services continuing to increase, innovations that maintain clinical effectiveness while reducing treatment complexity are likely to play an increasingly important role across the NHS.
Under NICE's draft recommendation, clinicians and patients should discuss all suitable treatment options and select the most cost-effective therapy that meets individual needs. Consideration should be given to medication costs, dosage requirements, administration costs and patient preferences.
Before Onswik can be routinely prescribed within the NHS, it must first receive licensing approval from the Medicines and Healthcare products Regulatory Agency (MHRA).
If approved, the treatment could represent one of the most significant changes to insulin delivery for people with type 2 diabetes in recent years.
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