Embargoed: NICE recommends weekly insulin jab that could cut injections from 365 a year to just 52

Hundreds of thousands of people with type 2 diabetes could swap daily insulin injections for a once-a-week jab, following a NICE recommendation today (Thursday, 20 August). The switch could cut the number of injections each patient needs by 85%. 

It will especially benefit people who need help 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. 

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. 

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

It could also help people who struggle to stick to their treatment routine. It may 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." 

Douglas Twenefour, Head of Clinical at Diabetes UK, said: “This recommendation is an important step towards giving people with type 2 diabetes greater flexibility in how their condition is managed. For some, especially those with additional care needs, moving from daily insulin injections to a once-weekly option could help manage their diabetes more easily, improving their quality of life. 

“Any NHS rollout should be supported by clear guidance, staff training and fair access. It's essential that everyone who could benefit is supported by their healthcare team to make informed decisions, and that this treatment helps reduce inequities in diabetes care.” 

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

Type 2 diabetes is a common condition where the body cannot make enough of a hormone called insulin, or the insulin it makes 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. 

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

The final draft guidance 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 full final draft guidance for insulin efsitora alfa for treating type 2 diabetes. 

ENDS