India Pharma Outlook Team | Friday, 25 September 2026
Diabetes care today advances on three fronts with new insulin, a new trial, and fresh funding.
In a single day, three separate advances reshape diabetes care. Eli Lilly secures FDA approval for once-weekly basal insulin.
Aqua Medical raises Series B capital to advance a pivotal U.S. trial of its investigational endoscopic procedure. Merck reports that its drug meets the main goal in a diabetic eye-disease study.
These moves span treatment innovation, a procedural alternative that targets metabolic pathways, and management of a serious complication.
Together they map the expanding spectrum of type 2 diabetes care from simpler daily management to intervention and protection of long-term vision. Patients and clinicians now see progress that reaches beyond conventional daily injections.
The U.S. Food and Drug Administration has approved Eli Lilly’s once-weekly basal insulin, Onswik (insulin efsitora alfa-gobe), for adults with type 2 diabetes. Patients can use the treatment alongside diet and exercise to control high blood sugar.
Onswik offers a clear practical advantage. It can cut the number of injections by more than 300 each year compared with once-daily basal insulin. Lilly will make the product available in the United States in the coming months as a pre-filled KwikPen in two concentrations; 500 units per milliliter and 1,000 units per milliliter.
The approval rests on a late-stage program that enrolled more than 3,400 adults with type 2 diabetes across four studies. Onswik met the main goal in every study and delivered A1C reductions that matched the performance of daily basal insulin glargine.
Important safety note:
Onswik already holds approvals in Europe, Japan and Mexico. The U.S. decision adds another weekly insulin option in a market that also includes Novo Nordisk’s Awiqli, which received FDA clearance earlier in 2026.
Also Read: 10 GLP-1 Drugs Revolutionizing Diabetes & Obesity Treatment
Aqua Medical has closed a Series B financing led by Relevance Ventures. The capital will support completion of the company’s ongoing U.S. RESTORE-1 pilot study and fund operational preparations for a planned U.S. pivotal trial of its investigational Proximal Intestinal Mucosal Ablation (PIMA) procedure.
PIMA forms part of Endoscopic Metabolic Restoration. Physicians deliver the treatment through the working channel of a standard endoscope to ablate targeted mucosa in the proximal small intestine.
The underlying radiofrequency vapor ablation system already carries FDA clearance for gastrointestinal ablation uses such as Barrett’s esophagus. Use of the system for PIMA remains investigational under an FDA Investigational Device Exemption.
Outside the United States, the company has treated 66 patients. Prior studies indicate that some patients become insulin-free after the procedure. Inside the United States, four patients have already undergone PIMA under the active IDE.
Type 2 diabetes affects 589 million people worldwide and drives more than USD 1 trillion in annual healthcare spending, including USD 327 billion in the United States. Aqua Medical positions the endoscopic approach as a minimally invasive alternative that sits between daily pharmaceuticals and major surgery.
Bob Haggerty, President and CEO of Aqua Medical, stated that the new support will advance the U.S. clinical program and generate the evidence needed for the next stage of development.
Merck has reported that its drug remigromig met the main goal in a mid- to late-stage trial in adults with diabetic macular edema. The medicine demonstrated non-inferiority to the control drug ranibizumab.
Diabetic macular edema causes swelling and fluid buildup in the macula, the central part of the retina. The condition can lead to blindness. Merck will present the full trial results at the upcoming annual meeting of the American Academy of Ophthalmology. This outcome adds a potential new tool for protecting vision in people who already live with type 2 diabetes and develop this sight-threatening complication.
Lilly simplifies insulin delivery with a weekly injection. Aqua Medical advances a through-the-scope procedure that aims to restore metabolic function. Merck strengthens the arsenal against a major diabetes-related eye disease.
Each development addresses a different layer of the patient journey that includes daily management, possible disease-modifying intervention, and complication control. On this single day the field of diabetes care has moved forward on all three fronts at once.
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