Diabetes — driven by our sedentary lifestyles and the widespread availability of high-calorie food —has become a modern epidemic. It’s a major risk factor not only for heart attacks and strokes but also for certain cancers. In the U.S., about 16% of the population has diabetes, and an alarming 38% are prediabetic, putting them on a path toward full-blown diabetes. A striking 90% of those affected are overweight or obese.

Given the strong link between weight and diabetes, the top three treatments remain the same: diet, diet and diet. Unfortunately, as most patients and physicians know, that’s easier said than done. As a result, treatment often begins with oral medications such as metformin or sulfonylureas (like glyburide or glimepiride) and may include once-weekly injectable GLP-1 receptor agonists like Ozempic or Mounjaro.

When these options aren’t enough to bring blood sugar to target levels, insulin therapy becomes necessary. But the current standard can involve up to five injections per day — a prospect many patients find frightening or outright refuse, often at the expense of their health.

Now, help may be on the horizon. Once-weekly insulin has been approved in Europe, but not yet in the U.S. That may soon change. This week’s New England Journal of Medicine featured promising results from trials of a new once-weekly insulin, Efsitora, showing it to be both safe and effective. The FDA is reviewing this and other weekly insulin formulations and given the strong demand from patients and providers alike, approval is widely expected.

While weekly insulin could be a game-changer in diabetes care, it’s important to remember that no medication can replace the foundation of treatment: diet. With nearly half the population already diabetic or prediabetic, now is the time to act — one week, one meal and one step at a time.

Dr. Charlie Barnett is a contributor at KnoxTNToday for a weekly column, DocTalk, providing his expertise on health and wellness management.

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