Oral Semaglutide for the Treatment of Patients of Type 2 Diabetes with Non-Alcoholic Fatty Liver Disease and Antipsychotic-Associated Weight Gain (AAWG) Not Responding to Metformin – A Case Series

Prevention and treatment of type 2 diabetes and obesity are problematic for individuals with schizophrenia and other patients on antipsychotic therapy because atypical antipsychotics and mental distress themselves increase appetite, thus promoting subsequent body weight gain and deterioration of glycaemic control. Almost half of patients with schizophrenia have body mass index (BMI) ≥ 25- and 2.5-times higher risk of developing T2D compared to healthy individuals [1]. Antipsychotic (AP) drugs are the cornerstone treatment for schizophrenia and are commonly used for other psychiatric disorders. However, they are associated with severe metabolic adverse effects, including weight gain, dyslipidaemia, and insulin resistance [2]. Particularly, insulin resistance and type 2 diabetes mellitus (T2DM) induce Non-alcoholic fatty liver disease (NAFLD) onset, deterioration of liver inflammation/fibrosis, and development of hepatocellular carcinoma. Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, accounting for approximately 25% of chronic liver disease cases worldwide [3].