Insulin Icodec (Awiqli®: Once-Weekly Basal Insulin)
Overview and Clinical Relevance
Insulin Icodec is the world’s first once-weekly basal insulin analogue for adults with diabetes requiring basal insulin therapy. It provides continuous glucose-lowering activity for one week, reducing injections from 365 to 52 per year. Launched in India in July 2026.
Mechanism of Action:
- Free insulin binds to insulin receptors (Tyrosine kinase receptors) on liver, muscles and adipose cells.
- This activates the PI3k-Akt pathway, causing GLUT4 translocation, increased Glucose uptake, suppresses hepatic glucose production, inhibits lipolysis and promotes glycogen synthesis.
- Its prolonged half-life is approximately 196 hours and supports stable once-weekly basal coverage.
Indications and Use
- Indicated for adults with Type 2 Diabetes Mellitus requiring basal insulin and selected adults with Type 1.
- Diabetes Mellitus needing basal insulin support. It may be useful for patients who struggle with daily basal insulin adherence.
Dosing and Administration
- Administer subcutaneously once weekly on the same day each week.
- Convert from existing daily basal insulin as per prescribing recommendations.
Adverse Effects and Monitoring
- Hypoglycemia,
- Injection-site reactions,
- Weight gain.
Key Counselling Points
- Take the injection on the same day every week.
- Continue regular glucose monitoring.
- Recognize and report symptoms of hypoglycemia.
- Do not change the dose without physician advice.
