Have we done everything possible for a patient with type 2 diabetes mellitus combined with obesity?

D. M. Antsiferova; O. M. Koteshkova; M. B. Antsiferov

doi:10.21518/ms2025-446

Have we done everything possible for a patient with type 2 diabetes mellitus combined with obesity?

D. M. Antsiferova, O. M. Koteshkova, M. B. Antsiferov

https://doi.org/10.21518/ms2025-446

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Abstract

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.

Keywords

diabetes mellitus, semaglutide, obesity, glucagon-like peptide-1 receptor agonists, metformin

About the Authors

D. M. Antsiferova

Endocrinology Dispensary of Moscow Healthcare Department; Russian Medical Academy of Continuous Professional Education
Россия

Daria M. Antsiferova, Endocrinologist; Postgraduate Student of the Department of Endocrinology

37, Prechistenka St., Moscow, 119034, Russia

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

O. M. Koteshkova

Endocrinology Dispensary of Moscow Healthcare Department
Россия

Olga M. Koteshkova, Cand. Sci. (Med.), Head of the Department of Diabetes Education and Treatment

37, Prechistenka St., Moscow, 119034, Russia

M. B. Antsiferov

Endocrinology Dispensary of Moscow Healthcare Department; Russian Medical Academy of Continuous Professional Education
Россия

Mikhail B. Antsiferov, Dr. Sci. (Med.), Professor, President; Professor

37, Prechistenka St., Moscow, 119034, Russia

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

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For citations:

Antsiferova DM, Koteshkova OM, Antsiferov MB. Have we done everything possible for a patient with type 2 diabetes mellitus combined with obesity? Meditsinskiy sovet = Medical Council. 2025;(16):161–168. (In Russ.) https://doi.org/10.21518/ms2025-446

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