India’s Diabetes Burden — and the Arrival of Once-Weekly Insulin
A look at the scale of the diabetes challenge in India and what Novo Nordisk’s Awiqli — the world’s first once-weekly insulin — means for patients going forward.
The Scale of the Diabetes Challenge in India
Diabetes has emerged as one of India’s most significant public health challenges, making the future of diabetes care more important than ever. A study published in The Lancet estimates that 101 million people in India — approximately 11.4% of the population — are living with diabetes. A separate survey commissioned by the Ministry of Health found that 136 million people (15.3% of the population) are living with prediabetes, placing them at high risk of developing type 2 diabetes.
Type 2 diabetes is the most common form of the disease. Insulin resistance occurs when the body either cannot produce enough insulin or cannot use it effectively causing blood glucose levels to remain consistently high.
Key Facts
● More than 101 million people in India are living with diabetes. Making it one of the country’s biggest chronic health challenges.
● After China, India has the second-largest diabetic population in the world.
● The International Diabetes Federation (Diabetes Atlas) estimates that by 2050. Approximately 900 million adults worldwide will be suffering from diabetes.
● It is estimated that by 2050 the number of adults suffering from diabetes in Southeast Asia will rise by 73%—increasing from 107 million to approximately 185 million—with India playing a major role in this increase.
● Millions of Indians suffer from diabetes without proper treatment and approximately 43% of those with the condition go untreated.
● More than 107 million people in India have pre-diabetes; if preventive measures are not taken they are at a very high risk of developing Type 2 diabetes.
These figures highlight the critical need for early screening, prompt diagnosis, professional medical advice, lifestyle changes and long-term, continuous diabetes care. Effective management of diabetes requires not only medication but also continuous patient education and preventive medical measures.
| 101M+ Indians living with diabetes | #2 Diabetic population ranking, worldwide | 43% Cases in India that go undiagnosed |
Why Is Diabetes Rising in India?
There are several reasons for this increase:
● Sedentary lifestyles
● Sedentary lifestyle High consumption of processed foods and refined carbs.
● Increasing obesity
● Urbanization
● Stress and poor sleep
● Family history and genetic susceptibility among South Asians
Why Early Detection Matters
Serious effects of uncontrolled diabetes can include:
- Stroke and heart disease
- Kidney failure
- Vision loss (diabetic retinopathy)
- Amputation and foot ulcers
- Nerve damage
The good news is that many of these outcomes can be avoided through early detection of the disease, lifestyle changes, regular check-ups and the use of appropriate medications and insulin when necessary.
The Latest Development in Diabetes Care
The End of Daily Insulin Shots? Meet Awiqli, the World’s First Once-a-Week Insulin
For nearly a century, insulin therapy has meant the same daily ritual: measure, inject, repeat — 365 times a year. That routine is now changing for millions of people with type 2 diabetes, thanks to a new drug from Novo Nordisk called Awiqli (insulin icodec-abae), which arrived in India in July 2026.
What Makes It Different
Awiqli is a long-acting basal insulin, but unlike traditional basal insulins that need to be injected every day, it’s designed to be taken just once a week. It’s formulated at a much higher concentration — 700 units per milliliter, compared to the 100 units per milliliter typical of standard insulins — which allows it to work in the body for days at a stretch. It’s delivered through a prefilled FlexTouch pen, the same style of device Novo Nordisk uses for several of its other injectable medications.
The math is striking: a typical daily insulin user injects themselves roughly 365 times a year. With Awiqli, that number drops to 52.
The Path to Approval
Awiqli’s approval was built on the ONWARDS clinical trial program, a set of four large phase 3 studies involving more than 2,600 adults with type 2 diabetes. These trials compared once-weekly icodec against daily basal insulin, both on its own and alongside other treatments like mealtime insulin or GLP-1 receptor agonists. Across the board, the weekly version matched or beat daily insulin at controlling blood sugar.
The U.S. Food and Drug Administration approved Awiqli in March 2026 for adults with type 2 diabetes, following earlier approvals in the European Union, Canada, Switzerland, and other markets. Notably, the FDA’s endorsement is currently limited to type 2 diabetes — an advisory panel had previously voted against extending it to type 1 diabetes, though without raising specific safety concerns for that use.
By July 2026, Awiqli had reached India, becoming just the sixth country in the world to offer the therapy — a significant milestone given India’s large diabetic population. A full U.S. launch is expected in the second half of 2026.
Why It Matters
Missed doses are one of the biggest hurdles in diabetes management. A single skipped daily injection can throw off blood sugar control and increase glucose variability. A weekly dosing schedule is far more forgiving — even a dose that’s a day or two late is less disruptive than a missed daily shot.
There’s also a convenience angle for patients already managing multiple weekly injectables. Many people with type 2 diabetes now take GLP-1 medications like semaglutide (Ozempic) or tirzepatide (Mounjaro) on a weekly basis. Awiqli raises the possibility of consolidating insulin and GLP-1 therapy into the same day, simplifying what can otherwise be a complicated medication routine.
A Caution Worth Noting
Awiqli’s biggest strength — its long-lasting, concentrated dose — is also why it demands careful use. Because it’s designed strictly for once-weekly administration, taking it more frequently than prescribed can be dangerous. Patients switching from a daily insulin regimen need clear guidance from their healthcare provider on dosing and timing during the transition.
The Bigger Picture
Awiqli represents more than a new drug — it reflects a broader shift in chronic disease management toward reducing the daily burden of treatment without compromising effectiveness. For a country like India, where a large share of diabetes cases go undiagnosed or under-treated, a simpler, more forgiving insulin regimen could meaningfully improve treatment adherence and outcomes for millions of patients.
This article is for informational purposes only and is not medical advice. Anyone considering a switch to a new insulin regimen should consult their doctor.