just so we’re clear, because i think someone could get that impression from these tags, oxytocin is NOT an opioid drug. oxyTOCIN (hormone, the subject of this post) and oxyCONTIN (opioid drug) look very similar and sound very similar but they are not even vaguely related despite nearly being anagrams

it is not an opioid or a painkiller. oxytocin is a hormone and neuropeptide that is involved in the way mammals form social bonds with each other. it cannot cross the blood-brain barrier, so when you take it orally, it ONLY affects your body, it does not affect your brain. thats why it’s in nasal spray form in these posts. in obstetric medicine, oral or IV oxytocin is used during labor to increase uterine contractions (edit: end help minimize bleeding), because in the body it is also involved in childbirth (both the physical act of giving birth and in boding with your baby/tolerating the people around you while you are in labor)

researchers have noticed for a long time that oxytocin levels in autistic people are generally very low, which in my opinion is exactly what autism “feels like” in social situations: ie, you are ambiently aware that hugging, physical touch, conversation either intimate or smalltalk level, and just being in proximity to people you care about should feel nice, everyone else seems to be having a good time, and they cant all be faking it. so what’s my problem? why does it stress me out so badly to be around people i actually want to be around and whom i trust and love? what am i MISSING that other people have? well, it might be the oxytocin for a lot of us. again, the studies on autism are 99% on “curing autism in children” and no one is interested at all in running research on improving quality of life in autistic adults, so the research we have on this is really stupid. but it offers some insight. autistic children given oxytocin nasal spray seem to respond with what you would expect from increasing someone’s low oxytocin levels: less social stress, better verbal fluency around people, better mood around people, etc.

you aren't supposed to laugh at your own jokes, so you don't, but then you're too serious. you're not supposed to be too loud, but then people say you're too quiet. you aren't supposed to get passionate about things, but then you're shy, boring. you aren't supposed to talk too much, but then people are mad when you're not good at replying.

you fold yourself into a prettier paper crane. since you never know what is "selfish" and what is "charity," you give yourself over, fully. you'd rather be empty and over-generous - you'd rather eat your own boundaries than have even one person believe that you're mean. since you don't know what the thing is that will make them hate you, you simply scrub yourself clean of any form of roughness. if you are perfect and smiling and funny, they can love you. if you are always there for them and never admit what's happening and never mention your past and never make them uncomfortable - you can make up for it. you can earn it.

don't fuck up. they're all testing you, always. they're tolerating you. whatever secret club happened, over a summer somewhere - during some activity you didn't get to attend - everyone else just... figured it out. like they got some kind of award or examination that allowed them to know how-to-be-normal. how to fit. and for the rest of your life, you've been playing catch-up. you've been trying to prove that - haha! you get it! that the joke they're telling, the people they are, the manual they got- yeah, you've totally read it.

if you can just divide yourself in two - the lovable one, and the one that is you - you can do this. you can walk the line. they can laugh and accept you. if you are always-balanced, never burdensome, a delight to have in class, champagne and glittering and never gawky or florescent or god-forbid cringe: you can get away with it.

you stare at your therapist, whom you can make jokes with, and who laughs at your jokes, because you are so fucking good at people-pleasing. you smile at her, and she asks you how you're doing, and you automatically say i'm good, thanks, how are you? while the answer swims somewhere in your little lizard brain:

how long have you been doing this now? mastering the art of your body and mind like you're piloting a puppet. has it worked? what do you mean that all you feel is... just exhausted. pick yourself up, the tightrope has no net. after all, you're cheating, somehow, but nobody seems to know you actually flunked the test. it's working!

For millions of people managing type 2 diabetes, mornings begin the same way — a needle, a dose, and a quiet mental note to do it all again tomorrow.

That routine just changed.

On March 26, 2026, the U.S. Food and Drug Administration approved Awiqli (insulin icodec-abae), developed by Novo Nordisk, as the first and only once-weekly basal insulin ever approved for adults with type 2 diabetes in the United States.

This is not a minor update to an existing drug.

It is the first entirely new class of basal insulin to reach U.S. patients in more than two decades.

Instead of injecting insulin every single day, people with type 2 diabetes using Awiqli will only need one shot per week, on the same day, every week.

That means reducing from 365 injections a year down to just 52.

For anyone who has ever felt the weight of that daily ritual — the anxiety of forgetting, the physical discomfort, the constant reminder that their body needs help — this approval represents something much bigger than a dosing schedule.

It represents relief.

How the Drug Actually Works

Understanding why this injection lasts a full week requires a quick look inside the body.

Most traditional basal insulins are absorbed into the bloodstream and begin breaking down within 24 hours, which is why patients need a fresh dose every day to maintain stable blood sugar levels.

Awiqli works differently.

Its active ingredient, insulin icodec-abae, is engineered to loosely attach to a blood protein called albumin, which is found naturally and abundantly in the bloodstream.

This attachment creates a slow-release reservoir.

Instead of flooding the system and fading fast, the insulin releases gradually and consistently over an entire seven-day period, keeping blood sugar in a healthy range around the clock...

The FDA reviewed and ultimately declined to approve it for people with type 1 diabetes, citing concerns about a modestly increased risk of hypoglycemia in that population specifically.

Some regulatory agencies in other countries, including the European Union, Canada, Australia, and Japan, have approved Awiqli for both type 1 and type 2 diabetes, but for now the U.S. approval is limited to type 2...

What Comes Next

Awiqli is not standing alone in this space for long.

Eli Lilly is developing its own once-weekly basal insulin, called efsitora alfa, which is currently in late-stage clinical trials.

If that drug also earns FDA approval, it would give patients and doctors two once-weekly options to choose from, allowing for personalized decisions based on a patient’s health profile, insurance coverage, and individual response.

The broader direction of travel in diabetes care is unmistakable.

Fewer injections, smarter formulations, and better integration with digital tools like continuous glucose monitors and insulin-tracking apps are all converging toward a future where managing diabetes requires less daily mental effort without becoming any less medically precise...

A Small Shot With Large Implications

It is easy to look at a once-weekly injection and see only a scheduling change.

But the science behind Awiqli, the scale of the ONWARDS trials, and the consistent satisfaction reported by patients all point toward something that matters far more than convenience.

Diabetes management has always asked a lot of people.

It asks for daily vigilance, daily discipline, and a daily willingness to confront one’s own condition, sometimes in uncomfortable or inconvenient circumstances.

Anything that reduces that load, without reducing the quality of care, is worth taking seriously.

For the more than 37 million Americans living with diabetes, and the hundreds of millions more around the world, a simpler weekly routine could mean the difference between a treatment plan that works on paper and one that actually works in a person’s life.

That is the real significance of what the FDA approved on March 26, 2026.

Not just a new drug.

A new way of keeping people healthy, one week at a time.