Danish pharmaceutical company Novo Nordisk launched insulin injection named 'Avikli' in India on July 9.
It is the world's first weekly basal insulin injection to be approved for clinical use.
The body of type 1 diabetes patients does not produce insulin on its own, so they depend on daily injections.
Similarly, in type 2 or gestational diabetes, when pills and lifestyle changes do not work, insulin is required. However, the dose of insulin is different for every patient.
How does insulin work and how will this new weekly injection help with treatment?
To know this, BBC News Punjabi spoke to Dr. Naveen Mittal, Head of the Department of Endocrinology, Dayanand Medical College and Hospital (DMCH), Ludhiana, and Dr. Shehla Shaikh, Consultant Endocrinologist, Saifee Hospital, Mumbai.
Avikli (whose generic name is insulin icodec) is an ultra-long-acting basal insulin for adult patients with type 1 and type 2 diabetes.
According to the company, with this a person will have to take 52 injections instead of 365 in a year.
According to a report by news agency Reuters, Vikrant Shrotaria, Managing Director of Novo Nordisk India, said that the price of one dose of 70 units of Avikli is Rs 261. It is available in two pen formats.
The price of 1 ml pen (700 units) is Rs 2,611 and the price of 3 ml pen (2,100 units) is Rs 7,833.
In comparison, the current price of 70 units of basal insulin used daily in India is between Rs 345 to Rs 453.
After America and European Union, India is the seventh country in the world to launch it.
According to Novo Nordisk estimates, more than 101 million people in India are suffering from some form of diabetes and 136 million are pre-diabetes.
People in India delay starting insulin by 7 to 9 years due to fear of injections and financial concerns. Currently about 60 lakh people are taking insulin.
Dr. Mittal explains that insulin Icodec has a different structure than other daily insulins like glargine or degludec, which work for 18 to 24 hours.
Because of this it is released slowly over a long period of time.
"The effect of natural insulin lasts only for 4 to 6 hours. Scientists have modified the insulin molecule through genetic engineering, so that after injection, insulin icodec binds to the albumin present in the blood."
"It is slow-release for up to 7 days and keeps sugar under control."
According to Dr Shaikh, "It is taken once a week. The daily dose is multiplied by 7 to determine the weekly dose."
"It is suitable for patients who have lost their response to pills or who are uncomfortable taking daily injections."
Avicly is approved in India only for adults aged 18 years and above.
According to Dr. Mittal, "It is good for adults with type 2 diabetes whose diabetes is not controlled by pills, but who are reluctant to take daily injections. It is also good for people who want relief from taking daily injections."
Basal Coverage: Avikly acts only as basal insulin and controls the background level of sugar in the body 24 hours a day.
Meal-time insulin: Patients who require short-acting (bolus) insulin when their blood sugar rises after meals are advised to continue taking these injections separately with Avicly.
Fewer injections: Only 52 injections a year instead of 365.
Regularity: Chances of missing a dose are less.
Lifestyle improvements: More convenient for busy or traveling people.
Better sugar control: Data shows that it provides better sugar control and reduces the risk of hypoglycemia (low blood sugar).
Helpful: Easy for people who live alone or are afraid of injections, as a family member can administer the injection once a week.
Dr. Mittal cautions that weekly dosing is convenient, but caution is necessary.
Risk of long-term hypoglycemia: The main risk of insulin is a severe drop in blood sugar. In case of daily insulin, the problem of low blood sugar can be corrected within 24 hours, but weekly insulin remains in the body for 7 days. Therefore the patient has to be monitored continuously.
Dosage: This insulin is highly concentrated, containing 700 units per milliliter. In this special pen, 1 click is equal to 10 units. Accidentally clicking too many times can result in an overdose.
Missing a dose or taking a double dose: Missing a dose or accidentally taking a double dose can make your diabetes worse throughout the week.
It may cause moderate risks such as low blood sugar or weight gain, although Icodec has been shown to reduce weight gain.
If blood sugar drops, follow the '15 minute rule'. That means eat something sweet immediately and check your blood sugar again after 15 minutes.
Experts say that these people should not use insulin icodec-
Children: Not approved for patients under 18 years of age.
Patients with unstable diabetes: Those whose blood sugar level fluctuates rapidly.
Those who do not feel its signs: People who do not feel its symptoms in the body when blood sugar falls.
