Clinical evaluation of semaglutide combined with metformin on treatment of patients with obesity/overweight type 2 diabetes mellitus
Feng Lin
Fu Zheng
Huang Huiping
Lin Fengsen
Abstract：Objective To explore the effect of semaglutide combined with metformin on treatment of patients with obesity/overweight type 2 diabetes mellitus(OB/OW-T2DM)and observe its influence on blood glucose control rates,insulin resistance and body fat parameters.Methods The patients with OB/OW-T2DM who were admitted to Ningde Municipal Hospital of Ningde Nor-mal University from June 2022 to October 2024 were included in the study and divided into the combined group(treated with sema-glutide combined with metformin)and the metformin group(treated with metformin)according to whether semaglutide was added for treatment.The propensity score matching method was used to exclude the influence of baseline data confounding factors,and 135 patients with comparable baseline data were obtained in each group.The two groups of patients were continuously treated for 3 months.The clinical efficacy,blood glucose control compliance rate(fasting plasma glucose(FPG)compliance rate,glycated hemoglobin(HbA1c)compliance rate,two-index compliance rate),blood glucose metabolisms(FPG,2 h postprandial blood glucose(2 h PG),HbA1c),insulin resistance-related indexes(adiponectin(APN),leptin(LEP),fasting insulin(FINS),homeostasis model assessment-insulin resistance index(HOMA-IR),islet β cell function index(HOMA-β))and body fat parameters(body mass index(BMI),waist-to-hip ratio(WHR),body fat rate)were observed and compared between the two groups before and after the treatment.The incidence rates of adverse reac-tions were statistically analyzed.Results The total effective rate was 94.07%(127/135)of the combined group after the treatment for 3 months,higher than 86.67%(117/135)of the metformin group,and there was significant difference between the two groups(χ2=4.256,P<0.05).The FPG compliance rate,HbA1c compliance rate and two-index compliance rate of the combined group were respective-ly 82.96%(112/135),78.52%(106/135)and 61.48%(83/135),higher than 72.59%(98/135),67.41%(91/135)and 40.00%(54/135)of the metformin group,and there were significant differences between the two groups(χ2=4.200,4.224,12.462,all P<0.05).The levels of FPG,2 h PG and HbA1c of the combined group and the metformin group were respectively(6.79±1.19)mmol·L-1,(8.12±1.21)mmol·L-1,(6.76±1.01)%,(7.61±1.23)mmol·L-1,(9.31±1.36)mmol·L-1 and(7.58±1.13)%after the treatment for 3 months,lower than(9.35±1.61)mmol·L-1,(12.76±2.25)mmol·L-1,(8.51±0.71)%,(9.26±1.43)mmol·L-1,(12.69±2.21)mmol·L-1 and(8.62±0.79)%before the treatment;the levels of the above indexes of the combined group were lower than those of the metformin group(t=5.567,7.596,6.286,all P<0.05).The levels of APN and HOMA-β of the combined group and the metformin group were respectively(7.53±1.42)mg·L-1,(66.73±5.61),(6.55±1.23)mg·L-1 and(61.72±5.01)after the treatment for 3 months,higher than(5.21±1.02)mg·L-1,(41.84±3.57),(5.16±1.01)mg·L-1 and(41.68±3.55)before the treatment;the levels of the above indexes of the combined group were higher than those of the metformin group(t=6.061,7.739,both P<0.05).The levels of LEP,FINS and HOMA-IR of the combined group and the metformin group were respectively(18.23±1.87)ng·mL-1,(12.25±1.57)mIU·L-1,(2.54±0.49),(20.34±2.09)ng·mL-1,(13.82±1.77)mIU·L-1 and(3.25±0.63)after the treatment for 3 months,lower than(22.44±2.32)ng·mL-1,(18.63±1.86)mIU·L-1,(4.23±0.82),(22.65±2.33)ng·mL-1,(18.59±2.13)mIU·L-1 and(4.26±0.84)before the treatment;the levels of the above indexes of the combined group were lower than those of the metformin group(t=8.742,7.710,7.195 P<0.05).The levels of BMI,WHR and body fat rate of the combined group and the metformin group were(26.28±1.48)kg·(m2)-1,(0.88±0.06),(30.35±1.81)%,(27.53±1.89)kg·(m2)-1,(0.92±0.03),and(31.83±1.93)%after the treatment for 3 months,lower than(29.25±2.51)kg·(m2)-1,(0.96±0.08),(34.24±2.01)%,(29.32±2.42)kg·(m2)-1,(0.95±0.09)and(34.35±2.07)%before the treatment;the levels of the above indexes of the combined group were lower than those of the metformin group(t=6.050,6.928,6.499,all P<0.05).There was no significant difference in the incidence rate of ad-verse reactions between the two groups(10.37%(14/135)vs 6.67%(9/135))(χ2=1.188,P>0.05).Conclusion Semaglutide combined with metformin is effective in the treatment of OB/OW-T2DM,which can significantly improve the blood glucose control rate,blood glucose metabolism level,insulin resistance-related indicators and body fat parameters,with favorable safety.
Keywords：Obesity/overweight type 2 diabetes mellitusSemaglutideMetforminBlood glucose control compliance rateBody fat parameter
Publication Date：2025-08-25
Online Publishing Date：2025-09-01(First online date of this platform, not the publication date of the document)
Pages：5( 829-833 )