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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2025-446</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-9548</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>САХАРНЫЙ ДИАБЕТ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DIABETES MELLITUS</subject></subj-group></article-categories><title-group><article-title>Все ли мы сделали для пациента с сахарным диабетом 2-го типа в комбинации с ожирением?</article-title><trans-title-group xml:lang="en"><trans-title>Have we done everything possible for a patient with type 2 diabetes mellitus combined with obesity?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3920-5914</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анциферова</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Antsiferova</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анциферова Дарья Михайловна, врач-эндокринолог; аспирант кафедры эндокринологии</p><p>119034, Россия, Москва, ул. Пречистенка, д. 37</p><p>125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1 </p></bio><bio xml:lang="en"><p>Daria M. Antsiferova, Endocrinologist; Postgraduate Student of the Department of Endocrinology</p><p>37, Prechistenka St., Moscow, 119034, Russia</p><p>2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia</p></bio><email xlink:type="simple">cifrenda@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8428-4116</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Котешкова</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Koteshkova</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Котешкова Ольга Михайловна, к.м.н., заведующая отделением обучения и лечения диабета</p><p>119034, Россия, Москва, ул. Пречистенка, д. 37</p></bio><bio xml:lang="en"><p>Olga M. Koteshkova, Cand. Sci. (Med.), Head of the Department of Diabetes Education and Treatment</p><p>37, Prechistenka St., Moscow, 119034, Russia</p></bio><email xlink:type="simple">koala58@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9944-2997</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анциферов</surname><given-names>М. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Antsiferov</surname><given-names>M. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анциферов Михаил Борисович, д.м.н., профессор, президент; профессор</p><p>119034, Россия, Москва, ул. Пречистенка, д. 37</p><p>125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1 </p></bio><bio xml:lang="en"><p>Mikhail B. Antsiferov, Dr. Sci. (Med.), Professor, President; Professor</p><p>37, Prechistenka St., Moscow, 119034, Russia</p><p>2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia </p></bio><email xlink:type="simple">antsiferov@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Эндокринологический диспансер Департамента здравоохранения города Москвы; &#13;
Российская медицинская академия непрерывного профессионального образования</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endocrinology Dispensary of Moscow Healthcare Department;&#13;
Russian Medical Academy of Continuous Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Эндокринологический диспансер Департамента здравоохранения города Москвы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endocrinology Dispensary of Moscow&#13;
Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>20</day><month>11</month><year>2025</year></pub-date><volume>0</volume><issue>16</issue><elocation-id>161–168</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Анциферова Д.М., Котешкова О.М., Анциферов М.Б., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Анциферова Д.М., Котешкова О.М., Анциферов М.Б.</copyright-holder><copyright-holder xml:lang="en">Antsiferova D.M., Koteshkova O.M., Antsiferov M.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/9548">https://www.med-sovet.pro/jour/article/view/9548</self-uri><abstract><p>Лечение коморбидных пациентов с сахарным диабетом 2-го типа (СД2) – серьезная проблема современной эндокринологии. Для больного СД2 важно не только достижение целевых параметров углеводного обмена (гликированного гемоглобина, глюкозы плазмы крови натощак и после приема пищи), но и снижение массы тела, улучшение показателей липидного спектра крови и артериального давления, а также улучшение течения коморбидных патологий, одной из которых является метаболически ассоциированная жировая болезнь печени (МАЖБП). Этого можно достигнуть с помощью семаглутида – препарата из группы агонистов рецепторов глюкагоноподобного пептида-1 (арГПП-1). В настоящее время семаглутид лидирует в данной группе препаратов по степени влияния на показатели гликемии, липидного профиля, массы тела, артериального давления, а также по эффективности в улучшении структуры печени у пациентов с МАЖБП. В многоцентровых клинических исследованиях было показано его выраженное кардио-, нефро- и гепатопротекторное действие, а также достоверное снижение риска развития и прогрессирования микро- и макрососудистых осложнений. В данной статье описан случай применения отечественного препарата Семавик у пациентки с длительным стажем СД2, сопутствующим абдоминальноконституциональным ожирением степени II и стеатозом печени. Больная находилась на монотерапии метформином. В связи с недостижением целевых показателей углеводного обмена была проведена интенсификация терапии препаратом Семавик (1 мг 1 раз в неделю). Полученные результаты показали высокую эффективность и безопасность двухкомпонентной терапии метформином в комбинации с семаглутидом в условиях реальной клинической практики. Использование в клинической практике отечественного препарата Семавик из группы арГПП-1 позволит повысить эффективность лечения и улучшить качество жизни больных СД2.</p></abstract><trans-abstract xml:lang="en"><p>Treatment of comorbid patients with type 2 diabetes mellitus (T2DM) is a serious challenge in modern endocrinology. For patients with T2DM, it is essential not only to achieve target carbohydrate metabolism parameters (hemoglobin HA1c, fasting and postprandial plasma glucose), but also to lose weight, improve blood lipid profiles and blood pressure, and ameliorate comorbid pathologies, one of which is metabolically associated fatty liver disease (MAFLD). This can be achieved using semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA). Currently, semaglutide leads in this class of drugs in terms of its impact on hypoglycemic and hyperglycemic ranges, lipid profile, body weight, and blood pressure, as well as its effectiveness in improving liver structure in patients with MAFLD. Multicenter clinical trials demonstrated its evident cardioprotective, nephroprotective, and hepatoprotective effects, as well as a significant reduction in the risk of development and progression of microvascular and macrovascular complications. This article presents a clinical case of the use of the domestic drug Semavic (semaglutide, Geropharm LLC) in a patient with long-standing type 2 diabetes, concomitant alimentary-constitutional obesity class II, and hepatic steatosis. The patient received metformin monotherapy. Due to failure to achieve target carbohydrate metabolism parameters, Semavic therapy was intensified (1 mg once weekly). The results demonstrated the high efficacy and safety of dual therapy with metformin combined with semaglutide in real-world settings. The clinical use of the domestic GLP-1RA will increase the treatment efficacy and improve the quality of life in patients with type 2 diabetes.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>сахарный диабет</kwd><kwd>семаглутид</kwd><kwd>ожирение</kwd><kwd>агонисты рецепторов глюкагоноподобного пептида-1</kwd><kwd>метформин</kwd></kwd-group><kwd-group xml:lang="en"><kwd>diabetes mellitus</kwd><kwd>semaglutide</kwd><kwd>obesity</kwd><kwd>glucagon-like peptide-1 receptor agonists</kwd><kwd>metformin</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Magliano DJ, Boyko EJ, Ali MK, Anstey K, Booth G, Duncan BB et al. IDF Diabetes Atlas. 11th ed. Brussels: International Diabetes Federation; 2025. 125 p. 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