Semaglutide: Multilevel organ protection in type 2 diabetes – from the heart and kidneys to peripheral vessels

Diabetes mellitus (DM) is one of the most burning issues in modern medicine. Its prevalence is growing at an alarming rate. In the Russian Federation, DM is registered in 3.5% of the population. Of these, the vast majority of people have type 2 diabetes. Today, most physicians give preference to glucose lowering medications with a high safety profile, a low risk of hypoglycemia and weight gain, and the ability to provide organ protection effect and reduce the risk of late complications. This group includes incretin-based drugs, primarily glucagon-like peptide-1 receptor agonists (GLP-1RAs). And first of all, it concerns long-acting GLP-1RAs, in particular semaglutide. Semaglutide allows most patients with diabetes to achieve target blood glucose and glycated hemoglobin levels, and also to significantly reduce body weight without causing hypoglycemia, either alone or with other glucose lowering medications and insulin. The numerous clinical studies have convincingly demonstrated that semaglutide has a broad spectrum of cardioprotective and nephroprotective effects, favourably affects inflammation and atherogenesis, and reduces the risk of progression of lower limb arterial diseases. According to the current clinical guidelines, the priority disease-modifying approach to the treatment should include GLP-1RAs or sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) in the treatment regimens. If target blood glucose levels have been previously achieved using other glucose lowering drugs, switching the patient to medications with proven benefits (GLP-1RAs or SGLT-2 inhibitors) by replacing prior drugs could be considered. Insudive® (semaglutide, solution for subcutaneous injection) that has been recently approved for marketing demonstrated similar safety, tolerability, and immunogenicity profiles to the reference product Ozempic®, according to the results of the pharmacokinetic and bioequivalence study.

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