Liraglutide

Liraglutide is a synthetic 31-amino-acid peptide that is 97% identical to human GLP-1, with a fatty-acid side chain that lets it bind albumin in the blood. That binding extends its half-life to roughly 13 hours, which allows once-daily dosing. It is a prescription medicine (Victoza for type 2 diabetes, Saxenda for weight management at a higher dose).

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.

• 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

1. 01Marso et al., Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER), NEJM 2016
2. 02Pi-Sunyer et al., A Randomized Controlled Trial of Liraglutide 3.0 mg in Weight Management (SCALE), NEJM 2015
3. 03European Medicines Agency — Victoza product information

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.