If you have diabetes, you may be considering different treatment options to manage your blood sugar. One option you may hear about is Awiqli (insulin icodec).
Awiqli is a once-weekly, long-acting insulin used to help control blood sugar levels in adults with type 2 diabetes. It is used along with a healthy diet and regular exercise. Awiqli is given as an injection under the skin using a prefilled pen on the same day each week.
Type 2 diabetes is a condition where the body has trouble keeping blood sugar levels in a healthy range. Over time, high blood sugar can lead to serious health problems, including heart disease, kidney damage, nerve problems, and vision loss. Many people need insulin to manage their diabetes, which often means doing injections every day.
Awiqli offers a different approach. The FDA approved it in March 2026 as the first long-acting insulin designed to last a full week.
Below are common questions and answers about Awiqli, how it works, and how it was studied for managing type 2 diabetes.
Awiqli Side Effects and Interactions: What to Expect and How to Manage Them
How Does Awiqli Work?
Insulin is a natural hormone that helps control blood sugar (glucose) levels. In people with type 2 diabetes, the body may not make enough insulin or may not use it effectively.
Awiqli works like natural insulin. It helps lower blood sugar by helping your body move sugar from the bloodstream into cells for energy. It also reduces how much sugar your liver makes.
Awiqli is designed to stay in your body longer than traditional insulin. After you inject it, its active ingredient, insulin icodec-abae, forms a temporary “storage pool” in the bloodstream by attaching to a protein called albumin. From there, the insulin is slowly and steadily released over time. This allows Awiqli to provide a consistent blood sugar-lowering effect throughout the entire week, similar to how natural insulin works in the body.
How Do I Use Awiqli?
Awiqli is a once-weekly injection given under the skin (subcutaneously). It should be used on the same day each week at any time of day.
Awiqli is injected using a prefilled FlexTouch pen. The pen can deliver doses in 10-unit increments and up to 700 units in one injection. Before using it for the first time, your health care provider should show you how to prepare and give the injection.
You can inject Awiqli into your stomach area (at least 2 inches away from your belly button), thigh, or upper arm. Be sure to rotate your injection site each week. This helps reduce the risk for irritation or skin changes, such as thickening or lumps.
When using Awiqli:
- Check the label each time to make sure you are using the correct insulin.
- Use the pen only if the liquid looks clear and colorless.
- Use a new pen needle for each injection (pen needles are included with Awiqli).
- Do not mix Awiqli with other insulins or medicines.
- Do not inject it into a vein or muscle.
Your dose will be personalized based on your blood sugar levels and treatment goals. Your prescriber may adjust your dose over time, so it is important to check your blood sugar as directed. Or you may want to try a continuous glucose monitor (CGM). This involves wearing a small sensor that automatically tracks your blood sugar levels throughout the day and night.
Dose changes may be needed if your kidney or liver function changes. However, because Awiqli lasts a long time in your body, your dose typically does not need to be adjusted for short-term illness or temporary changes in diet or physical activity. In those cases, your prescriber may recommend other adjustments, such as changes to food intake or other diabetes treatments.
Always follow your prescriber’s instructions, and ask if you have questions about how to use Awiqli safely. If you have trouble using Awiqli, ask your health care provider for help or call the drugmaker at 844-668-6463.
How Was Awiqli Studied for Type 2 Diabetes?
Researchers studied how well Awiqli works in adults with type 2 diabetes in four clinical trials.
The studies were designed to compare Awiqli to other insulin treatments. In all four studies, people were randomly assigned to receive either Awiqli or another insulin. In three of the studies, both the participants and researchers knew which treatment was being used. In one study, neither the participants nor the researchers knew who was receiving which treatment.
Individual doses were adjusted during the studies to reach target fasting blood sugar levels of 80-130 mg/dL. The main goal was to see how much Awiqli lowered A1c, which is a blood test that reflects your average blood sugar over the past two to three months.
Below, we’ll describe key details and results of each study.
Awiqli in Adults New to Insulin
Researchers studied Awiqli in adults with type 2 diabetes who had not used insulin before and still needed better blood sugar control despite taking other diabetes treatments.
These studies included people using common non-insulin therapies, such as GLP-1 agonists, metformin, or other oral diabetes medicines. Researchers wanted to see how well Awiqli worked compared to standard daily insulin options when added to these standard treatments.
Trial A. This study included 984 adults and lasted about one year. People were randomly assigned to receive either Awiqli once weekly or a daily long-acting insulin (insulin glargine). Most participants continued their usual diabetes medicines during the study.
The group of people in this study reflected a typical population with long-standing type 2 diabetes:
- The average age was 59 years, and 57% were male.
- People had been living with diabetes for about 12 years, on average.
- 66% were White, 28% were Asian, and 3% were Black or African American; 11% identified as Hispanic or Latino.
- Most participants had obesity; the average body mass index (BMI) was 30.1.
- Some people (11%) had reduced kidney function.
The main goal was to measure changes in A1c, which reflects average blood sugar over time. After 52 weeks, people using Awiqli had a slightly greater reduction in A1c compared to those using daily insulin. On average, A1c dropped by 1.51% with Awiqli and 1.33% with insulin glargine.
In addition, more people using Awiqli reached their blood sugar goal. About 57% of people on Awiqli achieved an A1c level below 7%, compared with about 45% of those using daily insulin.
Trial B. A second study followed 588 adults for about six months. In this study, Awiqli was compared to another daily long-acting insulin (insulin degludec). Participants continued their other diabetes treatments, although some doses were reduced at the start of the study.
The people in this study had similar characteristics:
- The average age was 58 years, and 63% were male.
- The average duration of diabetes was 11 years.
- 60% were White, 28% were Asian, and 3% were Black or African American; 28% identified as Hispanic or Latino.
- 8% had reduced kidney function.
- The average BMI was about 29.6 (overweight).
As in the first study, the main outcome was change in A1c. After 26 weeks, Awiqli again showed a slightly greater reduction in A1c compared to the daily insulin. A1c decreased by 1.56% with Awiqli and 1.34% with insulin degludec.
More people in the Awiqli group reached their target A1c: About 57% reached below 7% with Awiqli, and about 41% reached this goal with daily insulin degludec.
Awiqli in Adults Already Using Basal Insulin
Awiqli was also studied in adults with type 2 diabetes who were already using long-acting (basal) insulin but still needed better blood sugar control.
These studies looked at whether switching from a daily insulin to once-weekly Awiqli could provide similar or improved results.
Trial C. This study included 526 adults and lasted about six months. Participants were already using once- or twice-daily basal insulin, with or without other diabetes medicines. People were randomly assigned to either switch to Awiqli once weekly or continue treatment with a daily long-acting insulin (insulin degludec). Most participants continued their other diabetes treatments during the study.
The people in this study had long-standing type 2 diabetes:
- The average age was 62 years, and 57% were male.
- People had been living with diabetes for about 17 years, on average.
- 57% were White, 37% were Asian, and 4% were Black or African American; 6% identified as Hispanic or Latino.
- Some people (15%) had reduced kidney function.
- The average BMI was about 29.6 (overweight).
After 26 weeks, Awiqli led to a slightly greater reduction in A1c compared to the daily insulin. A1c decreased by 0.90% with Awiqli and 0.71% with insulin degludec.
More people using Awiqli reached their blood sugar goal. About 38% of people on Awiqli achieved an A1c level below 7%, compared with about 25% of those using daily insulin.
Trial D. This study included 582 adults and lasted about six months. Participants had type 2 diabetes that was not well controlled despite using a daily long-acting (basal) insulin along with mealtime (rapid-acting) insulin. People were randomly assigned to either switch to Awiqli once weekly or continue a daily long-acting insulin (insulin glargine). In both groups, participants continued taking mealtime insulin (insulin aspart) before each meal. Many participants also continued other diabetes treatments, such as oral medicines or GLP-1 agonists, although certain medicines (including sulfonylureas such as glipizide) were stopped at the start of the study.
The people in this study had the following characteristics:
- The average age was 60 years, and 52% were male.
- The average duration of diabetes was 17 years.
- 64% were White, 32% were Asian, and 4% were Black or African American; 18% identified as Hispanic.
- Some people (16%) had reduced kidney function.
- The average BMI was about 30.3 (obesity range).
In this study, Awiqli and daily insulin provided similar results. After 26 weeks, A1c decreased by 1.16% with Awiqli and 1.18% with daily insulin, showing that both treatments worked about the same. About 41% of people using Awiqli and 46% of people using daily insulin reached an A1c level below 7%.
Your results may differ from what was seen in clinical studies.
