FDA approves Onswik (efsitora), a second once-weekly basal insulin for type 2 diabetes

The FDA approved Eli Lilly's Onswik (insulin efsitora alfa-gobe), a basal insulin injected once a week, for adults with type 2 diabetes. In each of the four QWINT phase 3 trials, which together evaluated it in more than 3,400 adults, it lowered A1C (average blood sugar) by an amount non-inferior to daily insulin glargine or insulin degludec. It is the second once-weekly basal insulin approved in the US, after Novo Nordisk's Awiqli (insulin icodec) in March 2026, and its label says it should not be used in type 1 diabetes because of a higher risk of severe hypoglycaemia.