TCOYD The Podcast! Once-Weekly Basal Insulin for Type 2 Diabetes
Featuring TCOYD’s own Dr. Steve Edelman, with Dr. Athena Philis-Tsimikas, a leading diabetes researcher–directly involved in clinical trials of once-weekly basal insulins. This episode was supported by Lilly.
What if you could take your basal insulin once a week instead of every day? Once-weekly basal insulin offers a new approach that could make insulin therapy simpler while providing glucose control comparable to daily basal insulin.
In this episode, Dr. Steve Edelman is joined by Dr. Athena Philis-Tsimikas, a leading diabetes researcher who has been directly involved in clinical trials of once-weekly basal insulins. Together, they explain how these ultra-long-acting insulins work, how a single injection can provide steady background insulin throughout an entire week, and what studies have shown when once-weekly insulin is compared with traditional daily basal insulin.
They also discuss at how once-weekly insulin could make diabetes management easier. Going from seven basal injections a week to just one could help reduce some of the daily burden of diabetes and make it easier to consistently take your insulin. Together, they explore using weekly insulin alongside GLP-1 medications, potential combination therapies, cost and access, and what we still need to learn as these newer insulins move from clinical trials into everyday diabetes care.
Is this only for T2 diabetics or could it be used for a T1 diabetic combined with Novolog? I ask because I wear a CGM and have TIR 90% but I’d like my A1C lower than 7.0.
Great question–
It’s currently only approved in the U.S. for type 2 diabetes because there was a greater risk for hypoglycemia in the type 1 clinical trials. You can read more about the trial in T1D for Onswik (efistora) here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01804-X/abstract
Could this once weekly insulin act like Levemir did? I used to dose L in the morning and a split dose in the evening. I used R insulin for meals (low carbs with healthy fats). I achieved the steadiest values I’ve ever had. Nothing else I tried matched the Levemir. My numbers are okay on a pump system I’m on now but a lot more mental energy & stress with the technology.
I tried all the substitutes for Levemir but it wouldn’t handle split dosing a night. Any thoughts would be appreciated.
Pat M
I had a lot of patients who took Levemir twice a day to get a very even basal insulin profile. Saying that, I know that Levemir isn’t available anymore, and I know that a lot of folks like yourself are somewhat frustrated about that. The once-weekly basal insulin is a very smooth profile, and yes, it could replace twice-daily Levemir. However, remember, it’s not approved for patients with type 1 diabetes, which I am suspecting you are.
Thanks for the answer. Do you think it will ever be approved for type one diaberics?
I really do not know for sure, but at the current time I believe that both Novo and Lily are not planning to resubmit to the FDA for approval in type one diabetes.
Can it be use for Type2 as well? Im still not on insulin yet, but taking it only once a week is a comforting one..
Yes, weekly basal insulin is only approved for use in type 2 diabetes in the United States.
I guess this is not for pump users
As you know, pump users only use fast-acting insulin to give a small amount of insulin throughout the day (which is the “basal rate”) and before meals and for corrections, so no. There’s no long-acting insulin to be used in any insulin pump – only rapid-acting.
Can it be used with Omni pod ?
Pump users only use fast-acting insulin that gives a small amount of insulin throughout the day (the “basal rate”) and before meals and for corrections. There’s no long-acting insulin to be used in any insulin pump – only rapid-acting.
I’m afraid to ask, but how much?
Costs and coverage will depend on your insurance. Information regarding Onswik will be available soon, and you can check coverage for Awiqli on their website: https://www.awiqli.com/savings-and-support.html
Is it covered by insurance?
I take four shots a day for diabetes plus I take 2000 mg of metformin. I am so tired of all those shots.
Understandable! Check with your doctor to see if weekly basal insulin might be a good fit for you.