Side by side

1. 1.Activates GLP-1 receptors on pancreatic beta cells, raising glucose-dependent insulin release.
2. 2.Suppresses glucagon after meals.
3. 3.Slows gastric emptying, which is the main driver of its effect on post-meal glucose.
4. 4.Reduces appetite through central GLP-1 signalling.
5. 5.The added tail stabilises the peptide against DPP-4, allowing once-daily dosing.

• Type 2 diabetes as add-on therapy (GetGoal programme)
• Cardiovascular safety in high-risk type 2 diabetes (ELIXA)
• Combination with basal insulin
• Postprandial glucose control
• Weight as a secondary endpoint

• HbA1c reductions of roughly 0.5 to 0.9 percentage points
• Marked reduction in post-meal glucose excursions
• Modest weight loss
• ELIXA found no cardiovascular harm and no clear benefit
• More gastrointestinal effects than long-acting GLP-1 agonists

• Nausea and vomiting, more common with rapid dose escalation
• Diarrhoea
• Headache and dizziness
• Hypoglycaemia when combined with insulin or a sulfonylurea
• Pancreatitis (rare)
• Injection-site reactions

Research context only - prescription medicine. Labelled dosing is 10 micrograms subcutaneously once daily for 14 days, then 20 micrograms once daily, injected within an hour before the first meal of the day; ELIXA followed participants for a median of 25 months.

Research context only