Semaglutide: clinical efficacy, mechanisms of action, and therapeutic implications in the integrated management of type 2 diabetes mellitus and obesity

Abstract

Chronic metabolic diseases, such as Type 2 Diabetes Mellitus (T2DM) and obesity, represent a public health challenge due to their high prevalence and the complex impact on the cardiometabolic axis. Traditional management of these conditions presents limitations regarding glycemic control and modulation of body weight, justifying the search for therapies that act in a more integrated manner. This study aimed to critically analyze the role of GLP-1 receptor agonists, with emphasis on semaglutide, in the context of cardiometabolic diseases, considering pathophysiological foundations, clinical implications, and usage challenges. This is a narrative literature review conducted through searches in the PubMed, CAPES Journals, and Google Scholar databases, covering publications since 2016. Descriptors such as “semaglutide,” “type 2 diabetes mellitus,” and “weight loss” were used. Screening resulted in the selection of 15 studies, six (6) of which were Randomized Clinical Trials, considered the most relevant. The results confirmed the dual efficacy of semaglutide, evidenced by its potent reduction of HbA1c and clinically significant weight loss. The medication also demonstrated cardiovascular benefits and reductions in microvascular complications. It is concluded that semaglutide has solidified itself as a fundamental therapeutic tool in the integrated management of T2DM and obesity, but its use requires strict monitoring of adverse events, attention to dependence on continued therapy for weight maintenance, and ethical prescription that considers contemporary challenges related to off-label use and secondary aesthetic effects.