Weekly injection treatment for type 2 diabetes receives recommendation for use

The National Institute for Health and Care Excellence (NICE) offers an alternative to current daily injections.

People with type 2 diabetes currently taking insulin with a daily injection to treat their condition could now reduce their jabs dramatically – with a new weekly treatment.

It is estimated hundreds of thousands of people living with type 2 diabetes may be eligible to swap daily insulin injections for a once-a-week jab.

The switch could cut the number of injections required by each patient from 365 a year to just 52 – a difference of around 85%, following a recommendation from NICE.

The recently recommended treatment – insulin efsitora alfa, also known as Onswik and made by Eli Lilly – works just as well as insulins already used to treat type 2 diabetes despite only needing to be injected once a week.

Among those who may benefit from the less intensive insulin delivery schedule are people who require assistance to inject their insulin, as it will mean fewer visits from carers or healthcare workers, and less disruption to everyday life. This could particularly benefit some frailer people, and those with sight loss, limited hand movement, learning disabilities or difficulty following the steps involved.

Clinical trial evidence found the treatment could control blood glucose levels as well as two widely used long-acting insulins, insulin degludec and insulin glargine, which are taken to keep blood glucose steady throughout the day. Therefore people switching to the weekly injection can expect similar blood glucose control to their current treatment.  

The treatment could also help people who struggle to maintain their regular treatment routine. It could also benefit people under 40 with early-onset type 2 diabetes who are managing intensive treatment alongside working life.

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."

The weekly insulin can be used alone or alongside other treatments for type 2 diabetes.

Type 2 diabetes happens when people cannot create enough of the hormone insulin in their body, or when the insulin they make does not work properly (insulin resistance). Insulin helps the body use glucose (sugar) for energy. Without enough insulin, the level of glucose in a person’s blood becomes too high.

Latest figures show 4.6 million people in the UK were diagnosed diabetes mellitus (elevated blood glucose levels) in 2023-24, of which around 90% had type 2 diabetes.

The final draft guidance from NICE recommends healthcare professionals and patients should discuss the benefits and disadvantages of suitable options and choose the least expensive treatment that meets the person’s needs, taking account of dosage, administration costs, and price, after discussing the benefits and disadvantages of available options together.

NICE’s recommendation is subject to the treatment being licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) before it can be made available on the NHS.

Read the NICE Guidance on Insulin efsitora alfa for treating type 2 diabetes

Read more about type 2 diabetes