Patient wellbeing is one of the most important factors in any long-term medical treatment, and one of the greatest examples of this can be found in how we currently treat type 2 diabetes. With type 2, there is significant emphasis placed on the individual responsibility of the patient as well as on primary care staff, because unlike in type 1 there exists the possibility of reversal so long as efforts are maintained. This can, however, lead to additional stress placed on the patient, which, by proxy, calls patient compliance with long-term treatment(s) into question. If the diabetes was caused by dietary mismanagement or other lifestyle choices, these may also be symptomatic of other physical or mental health issues which could further complicate both treatment and recovery. At the centre of this picture lies the need to maintain good glycaemic control, and this has traditionally been done with a first line treatment involving metformin and strategic dietary changes, with sulphonylureas being called upon from the second line. Frustratingly, obesity is a comorbid in most people with type 2 diabetes, and this is exacerbated by the fact that adding multiple basal insulin doses into daily regimens is also associated with weight gain and an increased risk of hypoglycaemia. However, recent clinical trial evidence into the effects of an incretin-based treatment involving liraglutide may finally be about to change this. [1] 

Beginning with a randomised, double blind, placebo-controlled trial with a parallel group design conducted at 13 hospital-based outpatient clinics and one primary care unit in Sweden, scientists at the Research Centre for Laboratory Medicine at Karolinska University Hospital in Stockholm were able to show good glycaemic control combined with reductions in both body weight and insulin doses. It is theorised that besides liraglutide’s mechanism of action, which include insulinotropic and glucagonostatic effects, restricting glucagon secretion and stimulating the production of natural insulin, the drug may also be responsible for an increase in exogenous insulin being metabolised from the patient’s injections. The potential for reduction in daily doses in particular holds radical implications for primary care providers, because of direct impact on side effects. However, it is important that future research drills down on mechanisms of action and the pharmacokinetics of liraglutide (how the drug behaves inside the body) to optimise dose, regimen and thus mitigate adverse reactions from the treatment itself. The primary side effects of liraglutide were gastrointestinal symptoms, experienced by 46.9% of participants. Data regarding safety, such as the risk of pancreatitis, cancer and cardiovascular diseases will need to obtained moving forwards. [1]