On Sunday in Chicago, Dr. Athena Philis-Tsimikas, vice president of San Diego’s Scripps Whittier Diabetes Institute, helped deliver positive news for the estimated 7 million Americans who take insulin every day to manage their type 2 diabetes.

The endocrinologist and researcher was one of several investigators who presented Phase 3 clinical trial results at the 85th Scientific Sessions of the American Diabetes Association for a long-lasting type of insulin called efsitora alpha that was created by pharmaceutical giant Eli Lilly and Co.

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It was a deja vu for the local diabetes expert. She traveled to Stockholm in 2022, presenting trial results for another type of insulin called icodec, a similar long-lasting product marketed as Awiqli by Danish drug maker Novo Nordisk.

As was the case for Awiqli, the results for efsitora generally show that it is as effective as existing forms of insulin in controlling blood sugar. The key difference is that these drugs, due to clever chemical engineering, last in the bloodstream for a solid week, rather than just a single day. While delivering similar results, they reach their slow goals in different ways, with Awiqli binding with the blood protein albumen to deliver marathon longevity, while efsitora achieves its staying power by binding synthetic insulin molecules with a crystallized fragment of an immunoglobulin antibody.

The change can be dramatic for the estimated 20% to 30% of people with type 2 who need supplementary insulin.

Many are able to manage with once-daily shots of basal insulin, which maintains the body’s background insulin level, including while asleep. Others may also require fast-acting “bolus” insulin shots, most often before meals, if their body’s national production is quite low. Bolus shots are always necessary for those with type 1 diabetes, as that form of the disease destroys insulin-producing beta cells, while type 2 generally reduces, but does not eliminate insulin production. Basal insulin maintains the body’s

The day is coming, Philis-Tsimikas said, when it simply is no longer required to take basal insulin shots every day.

“It will be possible to take that basal shot just once per week,” she said.

But long-lasting insulin is far from the only recent advancement in diabetes treatment. Today, many are already taking pills daily that can prevent them from needing supplemental insulin or from needing bolus insulin shots by bolstering the body’s ability to eliminate glucose or coax the pancreas to produce more insulin than it otherwise would.

In some cases, Philis-Tsimikis said, these pills will still be necessary where the body’s natural insulin production has waned enough to need supplemental insulin but other medications have kept the disease from progressing to the point where bolus shots are required.

It’s already possible in Canada, the European Union and several other countries that have already approved Awiqli for both type 1 and type 2 diabetes. But Novo Nordisk’s approval in the U.S. has been delayed by questions about higher rates of low blood sugar, called hypoglycemia, in patients with type 1.

But it is widely speculated that the Danish drug maker will proceed with requesting type 2 approval while it sorts out the type 1 questions from the U.S. Food and Drug Administration. Lilly said in an email that it intends to file for type 2 approval from the FDA by the end of the year. While drug companies are famously cagy about predicting market availability too precisely, it appears that the availability of once-per-week insulin is nigh.

“(It’s my) opinion, of course, but I think a once-weekly insulin will be available in 2026,” Philis-Tsimikas said.

That arrival cannot come fast enough for Ronnie Williams, a medical assistant in the neurosurgery department at Scripps Health who participated in the efsitora trial.

Able to control his type 2 diabetes with basal insulin, the experience of giving himself just one shot per week instead of seven was hard to give up when the trial ended.

“It was mentally satisfying to know that you’re just taking it once a week rather than every day and then, you know, physically, it’s just easier on your body,” Williams said.

He said that he has not been able to use the drug for about one year as the trial results are pulled together and published.

“I’ve been waiting for the debut for a while, so I’ll be relieved when it’s available,” he said.