A Case Report on Therapeutic Optimization and Cardiometabolic Benefits of Semaglutide Therapy in Type 2 Diabetes Mellitus

Case Report

Abstract

Metabolic management in Type 2 Diabetes Mellitus (T2DM) is being shifted from a glucose-centric approach to a multi-organ protective strategy, particularly for patients presenting with comorbid obesity and hypertension. A 48-year-old female with a decade-long history of T2DM, characterized by a baseline HbA1c of 10.2%, a BMI of 36 kg/m², and poorly controlled hypertension, underwent a structured intervention with subcutaneous semaglutide. Over a 20-week period, a stepwise titration method was followed alongside Mediterranean-style dietary adjustments and aerobic exercise. Clinical outcomes revealed a 3.1% reduction in glycated hemoglobin, bringing the final HbA1c to 7.1%. Along with glycemic improvement, the patient showed a 9% reduction in total body weight (8.5 kg), resulting in a BMI decrease to 32.8 kg/m². Most importantly, the significant weight loss facilitated a stabilization of blood pressure, reducing the dependency on high-dose antihypertensive monotherapy. Improvements in the lipid profile, specifically a reduction in triglycerides and low-density lipoprotein cholesterol, further reduced the patient's cardiovascular risk. Minor gastrointestinal side effects were transient and managed through gradual dose escalation. These results show that semaglutide provides a combination of glycemic control, significant weight loss, and secondary cardiometabolic stabilization, reinforcing its utility as a high-priority agent in the management of obesity-associated diabetes