There’s a New Once-Weekly Insulin Shot for Type 2 Diabetes

Onswik is designed to deliver steady basal insulin over seven days, allowing people with type 2 diabetes to bypass daily injections.

It is the second medication in its class. The first, Awiqli, received FDA approval in March 2026.

“Weekly injections are advantageous because they greatly decrease the injection burden for patients,” says Jamie Alan, PharmD, PhD, an associate professor of pharmacology and toxicology at Michigan State University in East Lansing.

Onswik Supports Blood Sugar Management Similarly to Daily Injections, Clinical Trial Results Suggest

The FDA’s approval is based on four randomized controlled studies involving more than 3,400 adults with type 2 diabetes.

In the trials, Onswik was given once a week and compared with daily insulin injections. Participants continued their other diabetes treatments during the trials, including taking insulin at mealtimes.

Onswik reduced A1C (a measure of average blood sugar over the previous two to three months) similarly to daily insulin injections across the studies. The weekly injection also had a similar safety profile to daily injections.

• Low blood sugar
• Allergic reactions
• Reactions at the injection site
• Skin thickening or pits at the injection site
• Itching
• Rash
• Swelling of the hands and feet
• Weight gain

Onswik Is Only Approved for Adults With Type 2 Diabetes

This FDA Approval Can Help More Patients, According to Doctors

“Many patients are hesitant to start daily insulin injections,” says John Aurora, CDCES, PharmD, a clinical pharmacist and a diabetes educator at Tufts Medical Center in Boston.
“A weekly injection can be less intimidating and easier to do.”

Shifting injections to a weekly instead of daily schedule helps to ease some of the challenges for patients that come with injectable insulin, Dr. Alan says. “These can include — but are not limited to — things like injecting insulin while having a fear of needles, pain and bruising after injections, and storage issues, since insulin storage requires having refrigeration available,” she says.

People are also more likely to stick with an injectable medication when it’s weekly versus daily, Alan says. “That can improve clinical outcomes,” she says. “In this case, patients would likely see better control of their type 2 diabetes, which could look like preserving their kidney function and eyesight down the road.”

When Will Onswik Be Available and Will It Be Covered by Insurance?

The drug's maker, Eli Lilly, shared in a press release that Onswik will be available in the United States “in the coming months” in two concentrations: 500 units per milliliter (mL) and 1,000 units/mL.

It’s unclear what having another option for a weekly insulin shot will do for affordability. “Depending on insurance coverage, it may or may not be more affordable” to use a weekly insulin injection like Onswik instead of daily shots, Alan says.