Insulin Options Expand: OTC Regular and Once‑Weekly Formulations

Over‑the‑counter regular (R) insulin, an inexpensive older short‑acting formulation, is being marketed as a cheaper alternative for meal and correction doses in the United States, where the insulin‑price crisis has left many patients without affordable options. The drug begins working in about 30 minutes and lasts several hours, requiring careful timing. Experts such as Joshua J. Neumiller of the American Diabetes Association note its lower cost stems from expired patents, while clinicians like Shichun Bao of Vanderbilt Eskind Diabetes Clinic emphasize its continued utility for people unable to access newer rapid‑acting analogs.

In March 2026 the Food and Drug Administration approved Awiqli (insulin icodec‑abae), the first once‑a‑week insulin for adults with Type 2 diabetes. Weekly injection offers a convenient alternative to daily dosing, using the same injection sites (abdomen, thigh, upper arm) and similar storage and disposal practices. Patients are advised to follow prescriber instructions for dose conversion and site rotation to avoid injection‑site reactions.