New insulin injectable Awiqli offers convenient once-weekly injections for diabetes patients. GETTY IMAGES
Canadians living with diabetes will soon have access to the first-of-its-kind drug, Awiqli, a long-acting insulin injectable that is taken once per week. The drug, developed by Novo Nordisk, aims to provide another, more convenient option for people who use insulin injections to manage their blood sugar levels.
Dr. Alexander Abitbol, an endocrinologist and assistant medical director at LMC Healthcare, is excited about the release of the new option, as it gives people living with diabetes an even better chance at improved quality of life and a lower risk of complications that can arise when the disease is poorly managed.
“You’ll see a lot of people will have less eye problems, less nerve problems, less kidney problems, and society and these individuals as a whole will certainly benefit from another piece, another valued tool in the arsenal of diabetes management,” he said.
Up until the early 1990s, people living with diabetes had only three drugs of choice: insulin, sulfonylurea, and metformin. These drugs, while effective, didn’t provide many options for those who had to closely manage their blood sugar levels. By the late 1990s and early 2000s, several others were introduced into the market, including alpha-glucosidase inhibitors, meglitinides, and thiazolidinediones.
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Over time, it was shown that some of the drugs on the market were not safe for use and were pulled to make way for new options, and in 2005, the first-ever human insulin analogs were made available.
At the time, the introduction of these drugs changed the course of diabetes treatment, a course that is still active today, using insulin in new ways to provide more effective and convenient ways to manage diabetes.
Today, there are various ways to treat diabetes, including oral medications, injectable drugs, and wearable pumps. Mr. Andrew Halasz and Mrs. Judith Halasz, a couple who were diagnosed with diabetes 25 and 15 years ago, respectively, take daily injectables to manage their diabetes, with their treatment course starting with oral drugs all those years ago.
While a daily injection may seem cumbersome, both Mr. and Mrs. Halasz don’t find it that difficult because it means they get to remain healthy.
“It became second nature to both of us. I think to some extent, and I speak on behalf of my husband, too, the fact that we both have the same issues, it helps because we both keep an eye on each other,” Mrs. Halasz said. “We make sure that nobody forgets to take medication.”
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Both Mr. and Mrs. Halasz take special care of themselves—and each other—to avoid complications that can arise in people with poorly controlled diabetes.
Awiqli was born out of the idea of convenience, and those who struggle to take their insulin every day due to various factors, including work, travel, or social, can enter a new world of diabetes management using this drug. SUPPLIED
According to Dr. Abitbol, many people living with diabetes, both diagnosed and undiagnosed, are still at a high risk of complications due to a lack of adherence to treatment plans or a lack of knowledge of their current health situation.
“Unfortunately, many people in Canada with diabetes still don’t know they have diabetes, and in spite of great therapy, escalation in care, better monitoring tools, the statistics have persisted from the 90s,” he said.
“We’re only about 50 per cent … achieving that quote-unquote target for blood sugar, and the other 50 per cent remain with high blood sugar and are unfortunately still at higher risk for diabetes complications.”
Various complications that can develop due to consistently high blood sugar levels include an increased risk of heart disease and stroke, peripheral arterial disease, blindness, kidney disease, peripheral neuropathy, and lower-extremity amputations. Because of how severe these complications can be, ensuring that everyone living with diabetes has a drug that works for them is of the utmost importance.
Awiqli isn’t a new drug, per se, but rather a new take on a drug that’s been used for decades to help people living with diabetes—insulin. Insulin works by moving sugar out of the bloodstream and into bodily tissues to be used as energy so it doesn’t build up and cause issues.
Awiqli, works in the same way. The only difference is that it allows people to have one weekly injection versus daily injections. The insulin molecule used in the drug is designed to be ultra-slow release, so over the course of the week after the injection, it is slowly used by the body when needed as a way to keep blood sugar levels down.
While current therapies offer efficacy against the harmful effects of unmanaged diabetes, this drug provides something alongside that—convenience. Having to take a daily injection of insulin may be easy for some, but the freedom of a weekly injection for others can change how well they adhere to their treatment plans. It can also help those who are recently diagnosed be more open to the idea of taking insulin in the first place.
“(It takes time to) get that patient to actually accept that they have to go on insulin, and then, unfortunately, in about 30 to 40 per cent of cases, they accept, but they never fill the prescription,” said Dr. Abitbol. “So, they’re leaving the office with the idea that they’re actually going to be starting it but change their mind along the way.”
Awiqli was borne out of the idea of convenience, and those who struggle to take their insulin every day due to various factors, including work, travel, or social, can enter a new world of diabetes management using this drug.
When asked whether they see any benefit in Awiqli, Mr. and Mrs. Halasz see how good it can be for others but wouldn’t jump into trying it out without more information about side effects because of how comfortable they are with their current routine.
“For me, it wouldn’t make too much of a difference, but people who are working and travelling and involved with the day-to-day business activities … they can take that on a said day of the week, and they don’t have to worry about how to carry the insulin (or) how to protect it,” said Mr. Halasz.
