Obesity is often a comorbidity of type 2 diabetes mellitus (DM2), since up to 85.2% of people with 2MD are overweight or obese, and it is predicted that by 2025, more than 300 million people will have DM2 associated with obesity. In this case, when we analyze the relationship between diabetes, obesity and ozempic, there is much you need to know.
It is then assumed that weight loss has clinically significant implications in DM2, since weight loss not only improves glycemic control, but also influences cardiovascular risk factors, hypertension, dyslipidemia, sleep apnea, and nonalcoholic hepatic steatosis.
However, lifestyle-based strategies, such as diet, exercise and behavior change, may initially be successful, but after about 6 months it is possible to observe the appearance of the plateau effect followed by weight gain. This, in turn, justifies the need to consider new pharmacological approaches in order to obtain definitive results in these patients.
Pathophysiology of Obesity
Obesity is a chronic and complex disease characterized essentially by the accumulation of excess body fat and in its pathophysiology it is possible to observe neuroendocrine dysfunctions, genetic, metabolic and behavioral factors, practices and social customs which together result in increased body adipose tissue and outcomes that are potentially deleterious to the body.
In addition, it is important to highlight that obesity is directly related to increased fat accumulation in the liver, including other comorbidities such as type 2 diabetes mellitus, hypertension and cardiovascular diseases that are also related to increased mortality.
What is semaglutide and obesity and ozempic relationship
Known as Ozempic commercial name is indicated for the treatment of adults with type 2 diabetes mellitus, adjunct to diet and physical exercises, being presented as a 1.34mg/mL solution for injection in a completed application system, each application system contains 1.5ml and releases doses of 0.25mg and 5.0mg, applied once a week. The initial dose is 0.25mg, after four weeks the dose should be increased to 0.5mg, after four weeks, after this can be increased to 1.0mg (NOVO NORDISK, 2019).
However, it has been prescribed as an “off label” for the treatment of obesity because it is a natural incretin released by the intestine during meals that acts to maintain glucose at homeostatic levels through insulin secretion. In addition inhibits postprandial glucagon secretion and hepatic glucose production. That is, in healthy individuals, peak insulin after meals quickly leads to a reduction in plasma glucose levels, while in people with DM2, the effect of incretin is markedly decreased, resulting in higher and sustained plasma glucose concentration after carbohydrate intake.
Other effects associated with this medication are correlated with increased satiety sensation that induces a reduction in food intake and, consequently, body weight. Moreover, it is important to mention its ability to act delaying gastric emptying, improving insulin sensitivity and reducing hepatic glucose production and ectopic accumulation of lipids (outside adipose tissue).
Clinical practice
When it comes to diabetes, obesity and ozempic, it is clear that semaglutide demonstrates superiority when compared to other therapies in its class and can be an excellent proposal for therapeutic intervention associated with nutritional and lifestyle strategies for the management of patients suffering from one or both diseases. Since its mechanism of action involves a delay in gastric emptying that controls glycemic levels and reduces weight through caloric deficit resulting from a generally reduced appetitein addition to reducing the preference for foods with high fat content also have an effect on plasma lipids, which contributes to decreased systolic blood pressure and reduction of the inflammatory profile observed in these patients.
Bibliographic references
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Lazzaroni E, Ben Nasr M, Loretelli C, Pastore I, Plebani L, Lunati ME, Vallone L, Bolla AM, Rossi A, Montefusco L, Ippolito E, Berra C, D’Addio F, Zuccotti GV, Fiorina P. Anti-diabetic drugs and weight loss in patients with type 2 diabetes
. Pharmacol Res. 2021 Sep;171:105782. doi: 10.1016/j.phrs.2021.105782. Epub 2021 Jul 22. PMID: 34302978.
