The FDA has approved Onswik (insulin efsitora alfa-gobe), a long-acting insulin injected once a week, for adults with type 2 diabetes, along with diet and exercise. The agency's 2026 novel drug approvals list dates the approval to Sept. 23, and Eli Lilly announced it the next day. The label says Onswik is not recommended for people with type 1 diabetes because of an increased risk of severe low blood sugar, and its safety and effectiveness have not been established in children.
For adults who take daily basal insulin, the draw is convenience, not a stronger effect. Lilly's clinical trials showed Onswik lowered blood sugar about as well as daily insulin, not better. Onswik is the second weekly basal insulin approved in the United States, following Novo Nordisk's Awiqli in March.
