Side by side

1. 1.Binds and activates the GLP-1 receptor on pancreatic, gut and brain cells.
2. 2.Increases insulin release and reduces glucagon release in a glucose-dependent manner, so hypoglycaemia is uncommon on its own.
3. 3.Slows gastric emptying, so nutrients arrive in the small intestine more gradually.
4. 4.Acts on hypothalamic appetite centres to reduce hunger and food intake.
5. 5.Cardiovascular benefit seen in trials is thought to involve effects on inflammation, endothelial function and blood pressure in addition to weight loss.

• Type 2 diabetes (LEADER and the phase 3 programme)
• Chronic weight management in obesity (SCALE programme)
• Major cardiovascular events in type 2 diabetes (LEADER)
• Prediabetes and delay of type 2 diabetes onset
• Adolescent obesity (SCALE Kids)
• Obstructive sleep apnoea in obesity (secondary outcomes)

• HbA1c reduction of roughly 1–1.5 percentage points in trials
• Mean weight loss of about 8% at 56 weeks with the 3.0 mg dose (SCALE Obesity and Prediabetes)
• 13% relative reduction in major cardiovascular events in adults with type 2 diabetes at high risk (LEADER)
• Reduced progression from prediabetes to diabetes over three years
• Lower blood pressure and modest improvements in lipids

• Nausea, vomiting and diarrhoea, mostly during dose escalation
• Constipation and abdominal discomfort
• Gallbladder disease, including gallstones
• Pancreatitis (rare)
• Injection-site reactions
• Hypoglycaemia when combined with insulin or a sulfonylurea
• Thyroid C-cell tumours in rodents — human relevance not established

Research context only — liraglutide is a prescription medicine and its use is set by a doctor. Trials escalated weekly in steps: 0.6 mg to 1.8 mg daily for diabetes, or 0.6 mg to 3.0 mg daily for weight management, over 40–56 weeks. Nothing here is a dosing suggestion.

Research context only