Identifying Candidates for Once-Weekly Basal Insulin in Type 2 Diabetes, with Rachael Sood, NP-C, CDCES

Primary care physicians increasingly manage complex regimens for adults with type 2 diabetes, many of whom struggle with the daily burden of treatment. The FDA approval of once-weekly insulin icodec (Awiqli) offers an alternative to traditional once-daily basal insulin and may help simplify care for appropriate patients. By reducing the frequency of injections from 7 to 1 per week, this agent has the potential to improve adherence, lessen treatment fatigue, and support more consistent glycemic control. Insulin icodec is indicated for adults 18 years and older with type 2 diabetes to improve glycemic control as a once-weekly basal insulin option.¹

For primary care clinicians, the central question is not only whether the drug works but also which patients are most likely to benefit from a weekly basal strategy in real-world practice. Patients with variable schedules, travel demands, or established difficulty remembering daily medications may be especially well suited to a weekly basal insulin. In addition, individuals who are already managing multiple therapies—oral agents, GLP-1 receptor agonists, or other injectables—may experience meaningful relief from a reduced injection burden.

In the video above, Rachael Sood, NP-C, CDCES, founder of The Diabetes Collective, highlights that once-weekly insulin may be broadly applicable across the adult type 2 diabetes population, provided it is used within its labeled indication. She emphasizes that adults with unpredictable lives—such as parents, working adults with irregular hours, college students, and frequent travelers—often have practical difficulty with daily injections and may be strong candidates for a once-weekly basal option. Sood notes that simplifying the regimen to a single weekly injection can make it easier for patients to say “yes” to insulin initiation or intensification, potentially improving long-term outcomes among adults with type 2 diabetes.

References:

1. Novo Nordisk. FDA approves Novo Nordisk's Awiqli®, the first and only once-weekly basal insulin treatment for adults with type 2 diabetes. News release. March 26, 2026. Accessed March 27, 2026. https://www.prnewswire.com/news-releases/fda-approves-novo-nordisks-awiqli-the-first-and-only-once-weekly-basal-insulin-treatment-for-adults-with-type-2-diabetes-302726839.html