Weighing up the risks

It is important to balance the glycaemic benefits of semaglutide against any negative impacts on the patient’s appetite.

Paula, a 68-year-old retiree, was diagnosed with type 2 diabetes 10 years ago. She was initially managed with metformin but required the addition of insulin six years ago. She has a history of asthma, anxiety, gastro-oesophageal reflux disease, laparoscopic fundoplication and dyslipidaemia. She has no known micro- or macrovascular complications of diabetes and attends regular follow-up as recommended. Paula lives at home with her husband, and they share the household chores.

Her current diabetes management includes insulin isophane/insulin neutral 30/70 40 units mane and 28 units nocte and semaglutide 0.5mg via subcutaneous injection weekly.