Health officials in England have given initial backing to a once-weekly insulin injection for adults with type 2 diabetes, a move that could cut the number of jabs patients need each year by 86%. The National Institute for Health and Care Excellence (NICE) published final draft guidance on 19 August 2026 recommending the treatment, known as insulin efsitora alfa and marketed by Eli Lilly as Onswik, according to reporting from the Independent.
Before it reaches patients on the NHS, the drug still needs a licence from the UK's medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). Around 4.7 million people in the UK were living with diabetes in 2024-25, and roughly 90% of them had type 2, according to figures from the charity Diabetes UK, which estimates that one in four people with the condition currently takes insulin.
How does the weekly jab work, and how much does it cut injections?
Instead of a daily injection, patients would need to inject themselves only once a week, reducing the number of jabs needed annually from 365 to 52 — an 86% cut, according to the Independent's coverage of the NICE decision. The treatment is said to control blood sugar as effectively as existing daily insulin regimens. A 2024 trial summary found that adults using efsitora alfa saw a 1.34% reduction in a key blood-sugar marker, compared with a 1.26% reduction among those on the daily insulin degludec, according to a study summary reported by STAT News. The drug was tested through Eli Lilly's phase 3 QWINT trial programme, including studies labelled QWINT-1 and QWINT-3, ahead of the company's planned launch, according to trial reporting from ThePrint.
Who stands to benefit most from switching to a weekly injection?
The greatest benefit is expected for people who rely on others to help them inject, including those who are frailer, have sight loss, limited hand mobility or learning disabilities. People who struggle with the multiple steps of a daily injection, or who find it hard to keep to a strict daily routine, are also likely to gain from the switch.
Douglas Twenefour, head of clinical at Diabetes UK, said the change could ease the daily burden for many patients.
"For some, especially those with additional care needs, moving from daily insulin injections to a once-weekly option could help manage their diabetes more easily, improving their quality of life. It's essential that everyone who could benefit is supported by their healthcare team to make informed decisions, and that this treatment helps reduce inequities in diabetes care."
Helen Knight, director of medicines evaluation at NICE, said the decision followed careful weighing of patient benefit against NHS resources.
"[This could make a] real difference to the day-to-day lives of people with type 2 diabetes, especially those who rely on a carer, family member or healthcare professional to help them inject. This recommendation is the result of rigorous, evidence-based decision making, striking a balance between the benefits to patients and the best use of limited NHS funding."
How does this fit into the wider picture on diabetes treatment?
The push toward less frequent insulin dosing is not unique to the UK. In the United States, the Food and Drug Administration approved a separate once-weekly insulin, insulin icodec, made by Novo Nordisk, on 26 March 2026 for type 2 diabetes, according to an academic review published in Expert Opinion on Pharmacotherapy, showing that international drug developers are moving in parallel toward weekly insulin options. NICE's existing guideline on managing type 2 diabetes was last reviewed on 18 February 2026, forming the treatment framework into which this new recommendation would fit.
The announcement also comes amid wider concern about the spread of type 2 diabetes in the UK. Experts at Imperial College London have separately warned of a rise in type 2 diabetes diagnoses among women in their 20s, a trend they have linked to increases in obesity following the pandemic.
Which parts of the UK will get access, and what happens next?
NICE guidance formally applies only to the NHS in England, though the NHS in Wales frequently adopts its recommendations as well. In Northern Ireland, NICE guidance is not automatically adopted and is instead reviewed separately by the Department of Health, while in Scotland the decision-making process runs through the Scottish Medicines Consortium.
The immediate next step is a licensing decision from the MHRA. Health officials say they are waiting on that ruling to determine whether the weekly jab can actually be rolled out across the NHS, according to the Independent's report on the NICE announcement. Only once the MHRA has ruled would hundreds of thousands of eligible patients be able to move from daily injections to the new weekly regimen.
Key Facts
- NICE published final draft guidance on 19 August 2026 recommending insulin efsitora alfa (Onswik), made by Eli Lilly, for adults with type 2 diabetes.
- The weekly jab would cut annual injections from 365 to 52, an 86% reduction.
- Around 4.7 million people in the UK had diabetes in 2024-25, with about 90% having type 2, per Diabetes UK.
- MHRA licensing approval is still required before the treatment can be offered on the NHS.
- A separate weekly insulin, insulin icodec from Novo Nordisk, was approved in the United States on 26 March 2026.
