Starting Insulin? Here’s What to Know About Weekly Options

Starting insulin can feel like a big step, and many people have questions or worries about what it means. 

But needing insulin can be normal for many people with Type 2 diabetes. Today, there are more insulin options than ever before, including a once-weekly insulin that may make treatment easier for some people. Weekly insulin works just as well as daily basal insulin for many adults with Type 2 diabetes. This could mean 1 injection a week instead of 7.

Here’s what to know about how weekly insulin compares with daily insulin, and whether it may be the right option for you. 

Why do some people need insulin?

If your healthcare team recommends starting insulin, you’re not alone. About 1 in 3 people with Type 2 diabetes will eventually need to start taking insulin.

Needing insulin doesn’t mean you’ve done anything wrong. Type 2 diabetes changes over time. As it progresses, the cells in the pancreas that make insulin slowly stop working. This means your body makes less and less insulin. 

Many oral diabetes medicines and other treatments help your body use insulin better or help your pancreas release more insulin. But over time, your pancreas may not have enough insulin-making cells left for these medicines to work well on their own. When that happens, adding insulin is the best way to bring blood sugar back into a healthy range. 

Insulin treatment can help lower your risk of long-term diabetes complications. But studies suggest that only about half of the people who need insulin are actually taking it. 

Starting insulin can feel like a big step. The good news is that insulin treatment has come a long way. For many people, newer options make it easier to fit insulin into everyday life. 

What is weekly insulin?

Weekly insulin is a type of basal insulin. For most people, basal insulin is the first — and often only — type of insulin they use. It works all day and night to replace the insulin your pancreas can no longer make. 

Basal insulin is available as a daily injection or a once-weekly injection. 

Daily basal insulin has been used for many years. They include long-acting and ultra-long-acting insulins, such as: 

• Lantus (insulin glargine)

• Semglee (insulin glargine-yfgn)

• Rezvoglar (insulin glargine-aglr)

• Toujeo (insulin glargine)

• Tresiba (insulin degludec)

• Basaglar (insulin glargine)

An older, intermediate-acting insulin called NPH is also available. It has a higher risk of low blood sugar (hypoglycemia) if you miss a meal, and it may need to be taken twice a day. 

Awiqli (insulin icodec-abae) is an FDA-approved once-weekly basal insulin for adults with Type 2 diabetes. Like daily basal insulin, it provides a steady amount of insulin throughout the day and night to help manage blood sugar between meals and while you sleep.

Many people only need to take basal insulin. But if your blood sugar stays high after meals, your healthcare team may recommend adding fast-acting insulin for meals or another diabetes medicine.

Who should take weekly insulin?

Weekly insulin may be a good option for some adults with Type 2 diabetes who are starting basal insulin for the first time. 

It may be a good fit if you:

• Want fewer injections

• Feel nervous about starting insulin

• Think it may be hard to remember a daily injection

• Already take other diabetes medicines, such as metformin, SGLT2 inhibitors, or GLP-1 medications

• Want a simple treatment plan that may be easier to stick with

Weekly insulin isn’t the best choice for everyone. It may not be a good option if you:

• Have frequent episodes of low blood sugar (hypoglycemia)

• Need your insulin dose adjusted often

• Are pregnant or planning to become pregnant

Your healthcare team can help you decide if weekly insulin is right for you.

What are the benefits of weekly insulin vs. daily insulin?

Weekly insulin has several benefits for people who need to start basal insulin. These include:

• Fewer injections: You’ll take 52 injections a year instead of 365 with daily insulin.

• May be easier to start: Many people feel nervous about taking insulin every day. A once-weekly injection may make starting insulin feel less overwhelming.

• May be easier to stick with: Fewer injections may make it easier to remember your doses and stay on treatment.

• Works as well as daily insulin: Studies show weekly insulin lowers blood sugar as well as daily basal insulin for most people with Type 2 diabetes.

• More time in your target blood sugar range: Research suggests weekly insulin may help some people spend more time with their blood sugar in a healthy range.

• Low risk of low blood sugar: Studies found that weekly insulin has a similar, and sometimes lower, risk of low blood sugar than daily basal insulin.

Things to know before choosing weekly insulin

Weekly insulin can be a good option for many people, but there are a few things to know before you get started:

• You’ll still need to check your blood sugar or use a continuous glucose monitor (CGM). Your healthcare team will use these results to adjust your insulin dose if needed.

• It takes time to find the right dose. Your diabetes care team may gradually adjust your dose until your blood sugar is within target range.

• It takes a few weeks for the medication to work its best. Weekly insulin builds up slowly in your body before it reaches a steady level.

• If you miss your weekly injection, you can take it within 4 days. After that, skip the missed dose and take your next dose on your regular schedule.

• Like all insulins, weekly insulin can cause low blood sugar. Talk with your healthcare team about how to recognize and treat it.

Weekly insulin isn’t right for everyone. Talk with your healthcare team about your health history and other medications to make sure weekly insulin is a safe choice for you.

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Written by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, is an Arizona-based registered nurse with more than 20 years of hospital-wide clinical nursing experience. She has spent over a decade in medical writing and editing, with a focus on diabetes and autoimmune disease.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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