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As of April 2026, the MHRA and GPhC maintain that while menstrual changes are not primary side effects, they warrant documented clinical oversight

Patients ( N = 148) with type 2 diabetes with inadequate glycemic control on metformin (median duration of disease of 6.7 years, mean baseline HbA 1c 5557 mmol/mol [7.27.4%]) were randomised to receive lixisenatide (initiated at 10 g OD for 2 weeks followed by 20 g OD), or liraglutide (started at 0.6 mg and titrated up to 1.8 mg OD)

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Acknowledgements The authors thank Serena Rotunno for editorial assistance in the writing of this article