Russian-made pharmpreparation semaglutide in the experience of de-intensification of diabetes mellitus treatment: A clinical case

The actual concept of type 2 diabetes mellitus (T2DM) treatment includes optimizing the management of metabolic health, primarily glycemia and body weight, as well as preventing the development of cardiovascular diseases (CVD), chronic kidney disease (CKD), and metabolically associated fatty liver disease (MAFLD). Reduction of fat mass contributes to stable compensation of carbohydrate and lipid metabolism, control of blood pressure and reduction of cardiovascular risk, CKD and MAFLD. Glucagonlike peptide-1 (GLP-1Ap) receptor agonists are a highly effective class of drugs for the treatment of patients with T2DM, both by increasing the effectiveness and safety of glycemic control, and by having additional positive effects on the cardiovascular system and body weight. Studies have revealed numerous positive pleiotropic effects of semaglutide, which allows for better management of type 2 diabetes. For the first time in 2019 The Russian clinical guidelines and Algorithms for specialized medical care for patients with diabetes mellitus included information on the proven priority treatment of T2DM with CVD of atherosclerotic origin with GLP-1Ar class drugs. The development of a domestically reproduced drug, Semavik®, has made it possible to increase the availability of semaglutide preparations in the Russian Federation and expand the possibilities of pathogenetically based therapy providing cardiometabolic and other pleiotropic benefits in patients with T2DM. This clinical example presents the results of the efficacy and safety of the Russian semaglutide Semavik® in a patient suffering from long–term uncompensated T2DM, morbid obesity and receiving insulin therapy. Against the background of the addition of domestic GLP-1Ar to therapy, significant positive dynamics of glycemia and other metabolic parameters, weight loss, and improvement in objective examination indicators were achieved. The appointment of a domestic semaglutide made it possible to de-intensify insulin therapy in the form of its cancellation. The use of domestic semaglutide shows and proves its effectiveness not only in achieving the target values of blood glucose levels, but also in reducing body weight and normalizing the lipid profile.