Once-Weekly Insulin Could Cut Your Injections by Over 300 a Year—And It Works Just as Well

If you've been putting off starting insulin therapy because of the daily injections, there's encouraging news: Eli Lilly has developed a once-weekly insulin that works just as well as the daily versions most people use today. The findings come from three large clinical trials that tested this new medication, called efsitora alfa, against standard insulin treatments.

What Makes This Different?

The biggest difference is simple math: once-weekly efsitora means you'd give yourself roughly 52 injections per year instead of 365. That's over 300 fewer needle sticks annually. For many people with type 2 diabetes—a condition where your body struggles to control blood sugar levels because it can't use insulin effectively—this simplification could be life-changing.

"A simpler, once-weekly regimen with efsitora may help people with type 2 diabetes initiate and manage insulin therapy with the goal of improving blood sugar levels," said Julio Rosenstock, the lead researcher on one of the trials. The research team found that the medication uses a straightforward dosing approach with just four fixed-dose options, making it easier for patients to start and adjust their treatment without complicated calculations.

How Well Does It Actually Work?

Researchers tested efsitora in three separate Phase III trials involving different groups of people with type 2 diabetes. The first trial, called QWINT-1, included 795 insulin-naïve patients—people who had never taken insulin before. Over 52 weeks, efsitora reduced A1C (a measure of average blood sugar control over three months) by 1.31%, nearly identical to insulin glargine's 1.27% reduction. A1C is crucial because it shows how well your blood sugar has been controlled; lower numbers mean better diabetes management.

The second trial, QWINT-3, tested 986 patients who had previously used basal insulin (a long-acting background insulin). At 26 weeks, efsitora achieved a 0.86% A1C reduction compared to degludec's 0.75%. The third trial, QWINT-4, involved 730 people already using both basal and mealtime insulin. Both efsitora and insulin glargine achieved a 1.07% A1C drop at 26 weeks.

Safety and Side Effects

One concern with insulin therapy is hypoglycemia—dangerously low blood sugar. The good news: efsitora performed well here too. In QWINT-1, efsitora was associated with approximately 40% fewer hypoglycemic events than insulin glargine, with rates of 0.50 versus 0.88 per patient-year. In QWINT-4, nearly 40% of people taking efsitora reached their A1C targets without experiencing nocturnal hypoglycemia (low blood sugar at night).

Why This Matters Right Now

The numbers tell a sobering story about diabetes in America. An estimated 40.1 million people have diagnosed or undiagnosed diabetes, representing 12.0% of the U.S. population. Even more concerning, 115.2 million U.S. adults have prediabetes—a condition where blood sugar is higher than normal but not yet diabetic. Among adults aged 65 and older, 52.1% have prediabetes.

Many people with type 2 diabetes delay starting insulin because they're overwhelmed by the idea of daily injections. If efsitora becomes available, the once-weekly option could help more people get the insulin they need to control their blood sugar and prevent serious complications like diabetic neuropathy (nerve damage), kidney disease, and heart problems.

The research team is now working with regulatory agencies to bring efsitora to patients. While it's not yet available, these trial results suggest that managing type 2 diabetes could soon become simpler—and that might be exactly what millions of Americans need to take control of their health.