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UK NICE · UK · 20 Aug 2026 · Approval & opinion

NICE recommendation: weekly insulin injection for type 2 diabetes

Original title: Weekly insulin jab could cut injections from 365 a year to just 52

AI-generated summary

NICE recommends insulin efsitora alfa (Onswik) as a treatment option for type 2 diabetes, to be injected once weekly instead of daily. Clinical trials show it controls blood glucose as well as existing long-acting insulins. The recommendation applies to people with type 2 diabetes in the UK and could reduce injections by 85%, particularly benefiting those needing carer assistance or struggling with daily routines. The treatment requires MHRA licensing before NHS availability.

Dates and deadlines
Applies from
20 Aug 2025
From UK NICE

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.

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.

Excerpt from the official page. The original is authoritative.