Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly conventional second-line agents for hyperglycaemia in type-2 diabetes, with the Australian Diabetes Society and international guidelines elevating them into consideration as part of a patient-centred approach.

The latest Australian algorithm lists GLP-1RAs in no particular order with sodium-glucose co-transporter 2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP-4i) and sulfonylureas (SU) as second-line options, depending on clinical considerations and patient risks.

The algorithm dispels a common notion in primary care that injectable therapies are a last resort.

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus report provides more granularity on making treatment decisions, says Associate Professor Samantha Hocking, an endocrinologist at the University of Sydney and the Royal Prince Alfred Hospital.