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."
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
Notes to editors
The appeal period is now open and, barring appeal, the guidance
is expected to be finalised by Thursday, 10 September
2026.
Embargo
Information about technology
- Insulin efsitora alfa, (Onswik, Eli
Lilly) has not yet received its
marketing authorisation (license) from the MHRA.
- The technology needs to be licensed by the MHRA before it can
be used by NHS or private patients.
- It is taken as a once-weekly subcutaneous injection using a
pre-filled pen.
