A Danish pharmaceutical recently launched its weekly Insulin shot in India raising hopes for those striving with diabetes. Called Icodec, the drug will be sold under the brand name Awiqli for just Rs 261 per week. This is the world’s first long-acting insulin shot that reduces the number of pricks to just one in a week from once daily.
Hailing the development, managing director of Novo Nordisk India, said “Novo Nordisk has championed the cause of insulin. Insulin was discovered around 100 years ago, before which patients had to restrict their calorie intake to manage blood glucose, which led to people getting sicker. It took nearly 40 years to move from insulin with a short life to one with a 12-hour life and then one that could be taken once a day. Now, another 20 years later, we have a drug that can be taken just once a week,”
How will it help diabetic patients in India?
Insulin- an enzyme produced by pancreas to break down the glucose consumed by the body. In diabetes, the pancreas fails to produce sufficient amount of Insulin thereby leading to accumulation of glucose. To replicate human body like insulin- two modifications were adapted while developing Icodec.
Number 1 was the fatty acid chain addition. To increase the affinity to albumin- a protein in the blood fatty acid was added. When delivered subcutaneously weekly, the fatty acid bonds with albumin creating an inactive depot of the drug. This bond is reversible and the drug is slowly released into the bloodstream throughout the week.
Number 2 three amino acid substitutions were also made to lower the molecule’s affinity to insulin receptors. After the molecule gets out of the albumin bond, the reduced affinity for insulin receptor means that the drug gets used slowly. The reduced affinity does not reduce the potency of the drug in any way.
Approving the use of the drug, an endocrine specialist from New Delhi said, “The impact of this drug is similar to that of any other insulin. The advantage for the patients, however, is that it would reduce the number of shots they have to take. This is likely to improve compliance as well.“ Another specialist demonstrating an inertia to start his patients on the drug said, “Those living with diabetes for eight to ten years, with pills being unable to control the blood glucose levels, need to take insulin injections to prevent further complications. Yet, most of them are unwilling to switch to the shots. Around 93% of people wish for diabetes control without the use of insulin, and there is a need to change this mindset. Initiating insulin early can prevent damage to the organs, nerve endings, and the eye”.
How is it different from normal insulin tablets?
Icodec– is artificial insulin genetically engineered to mimic human insulin that increases it activity within the body giving better results. Now, most insulin is commercially manufactured and altered in various ways to increase the duration it stays in the body or improve the way it is absorbed.
While everyone with Type 1 diabetes needs insulin injections because their body does not produce the hormone, when it comes to the more common Type 2, many can be managed with oral pills. Yet, 25 to 30% of the people end up needing insulin eventually.
Who is the drug meant for?
The receivers of the drug can be categorised into two types– One, people with type 2 diabetes who have failed to achieve blood glucose control even with the highest doses of oral medicines.
Another in patients with type 1 diabetes who need a long-acting dose known as the basal dose, along with shots around the meal times known as the bolus dose, based on how many calories they consume.