Semaglutide significantly reduced body weight, HbA1c, and cardiometabolic risk in obese individuals with and without T2DM

Obesity and insulin resistance are critical drivers of cardiometabolic disease and type 2 diabetes mellitus (T2DM), conditions with increasing global prevalence. Current standard-of-care often struggles to achieve sustained weight loss and comprehensive cardiometabolic improvement. Glucagon-like peptide-1 (GLP-1) receptor agonists, like semaglutide, offer a promising therapeutic avenue by improving glycemic control, promoting weight loss, and exerting beneficial effects on cardiovascular risk factors. This study aimed to provide real-world evidence on semaglutide's efficacy in a diverse obese population, addressing the gap in understanding its broad cardiometabolic impact.

This retrospective longitudinal observational study included 70 adults with obesity, comprising 42 with T2DM and 28 without. Participants received semaglutide treatment according to current clinical guidelines, reflecting real-world clinical practice. Primary outcomes measured changes in body weight, waist circumference, fasting plasma glucose, and glycated hemoglobin (HbA1c). Secondary outcomes included alterations in lipid profiles, insulin resistance indices (e.g., HOMA-IR), inflammatory markers, hepatic parameters, and body composition, which was precisely assessed using bioelectrical impedance analysis (InBody770). The study also explored baseline predictors of treatment response.

Semaglutide treatment yielded significant improvements across multiple cardiometabolic parameters. Participants experienced an average reduction in body weight of -9 kg, accompanied by a decrease in waist circumference of -8 cm. Glycemic control improved markedly, with HbA1c levels dropping by -1.1%. Systolic blood pressure saw a reduction of -7.5 mmHg, and visceral fat area decreased by -30.1 cm2, indicating substantial improvements in adiposity. Insulin resistance markers also showed significant reductions. Notably, skeletal muscle mass (SMM) was relatively preserved throughout the treatment period, a crucial finding for maintaining metabolic health. Improvements in glycemic parameters were more pronounced in the subgroup of participants with T2DM. Baseline HbA1c and visceral adiposity were identified as independent predictors, significantly associated with the overall metabolic response to semaglutide. This suggests that initial metabolic status can influence treatment efficacy.

Semaglutide treatment led to an average 9 kg body weight reduction and 1.1% HbA1c decrease, alongside significant improvements in visceral fat and blood pressure.