diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13441diaendo-13453Research ArticleОригинальные исследованияOriginal StudiesОценка эффективности семаглутида в обеспечении метаболического контроля и коррекции инсулинорезистентности у больных сахарным диабетом 2 типа в условиях реальной клинической практикиEvaluation of the effectiveness of semaglutide in providing metabolic control and correction of insulin resistance in patients with type 2 diabetes mellitus in real clinical practicehttps://orcid.org/0000-0002-3920-5914АнцифероваД. М.AntsiferovaD. M.

Анциферова Дарья Михайловна, аспирант 

119034, г. Москва, ул. Пречистенка, д. 37 

Daria M. Antsiferova, MD, PhD student 

37 Prechistenka street, 119034 Moscow 

cifrenda@yandex.ruhttps://orcid.org/0000-0002-7936-7619АметовА. С.AmetovA. S.

Аметов Александр Сергеевич, д.м.н., профессор 

Москва

Alexander S. Ametov, MD, PhD, Professor 

Moscow 

alexander.ametov@gmail.comhttps://orcid.org/0000-0001-8428-4116КотешковаО. М.KoteshkovaO. M.

Котешкова Ольга Михайловна, к.м.н. 

Москва

Olga M. Koteshkova, MD, PhD 

Moscow 

koala58@mail.ruРомашкинаЛ. П.RomashkinaL. P.

Ромашкина Лада Павловн 

Lada P. Romashkina, MD 

Moscow 

ladina09@mail.ruhttps://orcid.org/0000-0002-9944-2997АнциферовМ. Б.AntsiferovM. B.

Анциферов Михаил Борисович, д.м.н., профессор 

Москва

Mikhail B. Antsiferov, MD, PhD, Professor 

Moscow 

antsiferov@rambler.ruЭндокринологический диспансер ; Российская медицинская академия непрерывного профессионального образованияРоссияEndocrinology Dispensary ; Russian Medical Academy of Continuous Professional EducationRussian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationЭндокринологический диспансерРоссияEndocrinology DispensaryRussian Federation2026110220262914049Copyright © Анциферова Д.М., Аметов А.С., Котешкова О.М., Ромашкина Л.П., Анциферов М.Б., 20262026Анциферова Д.М., Аметов А.С., Котешкова О.М., Ромашкина Л.П., Анциферов М.Б.Antsiferova D.M., Ametov A.S., Koteshkova O.M., Romashkina L.P., Antsiferov M.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13453АКТУАЛЬНОСТЬ

АКТУАЛЬНОСТЬ. Сахарный диабет 2 типа (СД2) тесно связан с ожирением и инсулинорезистентностью (ИР). Семаглутид, агонист рецепторов ГПП-1, проявляет выраженные эффекты в отношении гликемического контроля и массы тела, однако данные о его влиянии на различные суррогатные индексы ИР в условиях рутинной практики ограничены.

ЦЕЛЬ

ЦЕЛЬ. Оценить влияние семаглутида (Семавик®) на метаболический контроль и ИР у пациентов с СД2 и ожирением, не достигших целевых показателей углеводного обмена на монотерапии метформином.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В проспективное исследование включили 31 пациента 40–65 лет с СД2, ИМТ 30,0–39,9 кг/м² и HbA1c 7,0–9,0% на фоне метформина; 28 пациентов завершили 24-недельное наблюдение. Оценивали антропометрические показатели, биоимпедансный состав тела, HbA1c, гликемию натощак, инсулин, С-пептид, свободные жирные кислоты и рассчитывали индексы HOMA-IR, QUICKI, TyG, Adipo-IR и молярное соотношение С-пептид/инсулин.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Через 24 недели терапии семаглутидом отмечено достоверное снижение массы тела (медиана −8,2% или 8,58 кг), ИМТ, окружности талии и жировой массы, а также улучшение показателей углеводного обмена: HbA1c снизился с 7,63% до 6,25%. 85,7% пациентов достигли HbA1c<7,0%. Выявлено значимое снижение HOMA-IR, TyG, Adipo-IR, повышение QUICKI и молярного соотношения С-пептид/инсулин, что указывает на уменьшение ИР на уровне печени, жировой и периферических тканей. Нежелательные явления наблюдались у небольшой части пациентов и носили в основном диспепсический временный характер.

ВЫВОДЫ

ВЫВОДЫ. Семаглутид у пациентов с СД2  ожирением в реальной клинической практике обеспечивает клинически значимое уменьшение массы тела, улучшение гликемического контроля и многокомпонентное снижение ИР при благоприятном профиле безопасности.

RELEVANCE

RELEVANCE. Type 2 diabetes mellitus (DM2) is closely related to obesity and insulin resistance (IR). Semaglutide, glucagon-like peptide-1 receptor agonist, exhibits pronounced effects on glycemic control and body weight. However, data on its effect on various surrogate IR indices in routine practice are limited.

AIM

AIM. To evaluate the effect of semaglutide (Semavic®) on metabolic control and IR in patients with DM2 and obesity who did not achieve the target values of carbohydrate metabolism on metformin monotherapy.

MATERIALS AND METHODS

MATERIALS AND METHODS. The prospective study included 31 patients aged 40–65 years with DM2, BMI 30.0–39.9 kg/m2 and HbA1c 7.0–9.0% on metformin treatment; 28 patients completed a 24-week follow-up. Anthropometric parameters, bioimpedance body composition, HbA1c, fasting glycemia, insulin, C-peptide, free fatty acids were evaluated. HOMA-IR, QUICKI, TyG, Adipo-IR indices, C peptide/insulin molar ratio were calculated.

RESULTS

RESULTS. After 24 weeks of semaglutide therapy, there was a significant decrease in body weight (median -8.2% or 8.58 kg), BMI, waist circumference and fat mass as well as an improvement in carbohydrate metabolism: HbA1c had decreased from 7.63% to 6.25%, 85.7% of patients reached HbA1c <7.0%. There was a significant decrease of HOMA-IR, TyG, Adipo-IR indices, an increase of QUICKI and C peptide/insulin molar ratio indicating a decrease of IR in the liver, adipose and peripheral tissues. Adverse events were observed in a small proportion of patients and were mainly of a temporary dyspeptic nature.

CONCLUSIONS

CONCLUSIONS. Semaglutide in patients with DM2 and obesity in real clinical practice provides a significant reduction of body weight, improves glycemic control and leads to multicomponent reduction of IR with a favorable safety profile.

сахарный диабетожирениесемаглутидинсулинорезистентностьdiabetes mellitusobesitysemaglutideinsulin resistanceСпонсор исследования — ООО «Герофарм», Россия.ReferencesIDF Diabetes Atlas. 10th Edition. International Diabetes Federation, 2021IDF Diabetes Atlas. 10th Edition. International Diabetes Federation, 2021Boutari C, DeMarsilis A, Mantzoros CS. Obesity and diabetes. Diabetes Res Clin Pract. 2023;202:110773. doi: https://doi.org/10.1016/j.diabres.2023.110773Boutari C, DeMarsilis A, Mantzoros CS. Obesity and diabetes. Diabetes Res Clin Pract. 2023;202:110773. doi: https://doi.org/10.1016/j.diabres.2023.110773Майоров А.Ю., Урбанова К.А., Галстян Г.Р. и др. Методы количественной оценки инсулинорезистентности // Ожирение и метаболизм. — 2009. — Т. 6. — №2. — С. 19-23. doi: https://doi.org/10.14341/2071-8713-5313Mayorov AY, Urbanova KA, Galstyan GR, et al. Methods for guantificative assessment of insulin resistance. Obesity and metabolism. 2009;6(2):19-23. (In Russ.) doi: https://doi.org/10.14341/2071-8713-5313Katz A, Nambi SS, Mather K, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402-2410. doi: https://doi.org/10.1210/jcem.85.7.6661Katz A, Nambi SS, Mather K, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402-2410. doi: https://doi.org/10.1210/jcem.85.7.6661Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351. doi: https://doi.org/10.1210/jc.2010-0288Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351. doi: https://doi.org/10.1210/jc.2010-0288Сорокина Ю.А., Занозина О.В., Постникова А.Д. Индексы инсулинорезистентности: возможность и необходимость их применения для оптимизации ведения больных сахарным диабетом 2-го типа // Клиническая медицина. — 2020. — Т. 98. — №7. — С. 529-535. doi: https://doi.org/10.30629/0023-2149-2020-98-7-529-535Sorokina YA, Zanozina OV, Postnikova AD. The insulin resistance indices: necessity and opportunities in type 2 diabetes mellitus management. Clinical Medicine (Russian Journal). 2020;96(7):529-535. (In Russ.) doi: https://doi.org/10.30629/0023-2149-2020-98-7-529-535Li Y, Li H, Chen X, Liang X. Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys. Front Endocrinol (Lausanne). 2024;15:1483468. doi: https://doi.org/10.3389/fendo.2024.1483468Li Y, Li H, Chen X, Liang X. Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys. Front Endocrinol (Lausanne). 2024;15:1483468. doi: https://doi.org/10.3389/fendo.2024.1483468Yin H, Huang W, Yang B. Association between METS-IR index and obstructive sleep apnea: evidence from NHANES. Sci Rep. 2025;15(1):6654. doi: https://doi.org/10.1038/s41598-024-84040-9Yin H, Huang W, Yang B. Association between METS-IR index and obstructive sleep apnea: evidence from NHANES. Sci Rep. 2025;15(1):6654. doi: https://doi.org/10.1038/s41598-024-84040-9Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-1495. doi: https://doi.org/10.2337/diacare.27.6.1487Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-1495. doi: https://doi.org/10.2337/diacare.27.6.1487Chen H, Sullivan G, Yue LQ, et al. QUICKI is a useful index of insulin sensitivity in subjects with hypertension. Am J Physiol Endocrinol Metab. 2003;284(4):E804-E812. doi: https://doi.org/10.1152/ajpendo.00330.2002Chen H, Sullivan G, Yue LQ, et al. QUICKI is a useful index of insulin sensitivity in subjects with hypertension. Am J Physiol Endocrinol Metab. 2003;284(4):E804-E812. doi: https://doi.org/10.1152/ajpendo.00330.2002Yokoyama H, Emoto M, Fujiwara S, et al. Quantitative insulin sensitivity check index and the reciprocal index of homeostasis model assessment are useful indexes of insulin resistance in type 2 diabetic patients with wide range of fasting plasma glucose. J Clin Endocrinol Metab. 2004;89(3):1481-1484. doi: https://doi.org/10.1210/jc.2003-031374Yokoyama H, Emoto M, Fujiwara S, et al. Quantitative insulin sensitivity check index and the reciprocal index of homeostasis model assessment are useful indexes of insulin resistance in type 2 diabetic patients with wide range of fasting plasma glucose. J Clin Endocrinol Metab. 2004;89(3):1481-1484. doi: https://doi.org/10.1210/jc.2003-031374Chen H, Sullivan G, Quon MJ. Assessing the predictive accuracy of QUICKI as a surrogate index for insulin sensitivity using a calibration model. Diabetes. 2005;54(7):1914-1925. doi: https://doi.org/10.2337/diabetes.54.7.1914Chen H, Sullivan G, Quon MJ. Assessing the predictive accuracy of QUICKI as a surrogate index for insulin sensitivity using a calibration model. Diabetes. 2005;54(7):1914-1925. doi: https://doi.org/10.2337/diabetes.54.7.1914Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299-304. doi: https://doi.org/10.1089/met.2008.0034Simental-Mendía LE, Rodríguez-Morán M, GuerreroRomero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299-304. doi: https://doi.org/10.1089/met.2008.0034Lee SH, Kwon HS, Park YM, et al. Predicting the development of diabetes using the product of triglycerides and glucose: the Chungju Metabolic Disease Cohort (CMC) study. PLoS One. 2014;9(2):e90430. doi: https://doi.org/10.1371/journal.pone.0090430Lee SH, Kwon HS, Park YM, et al. Predicting the development of diabetes using the product of triglycerides and glucose: the Chungju Metabolic Disease Cohort (CMC) study. PLoS One. 2014;9(2):e90430. doi: https://doi.org/10.1371/journal.pone.0090430Шиповская А.А., Курбатова И.В., Ларина Н.А., Дуданова О.П. Сравнительная характеристика триглицеридглюкозного индекса и гомеостатического индекса инсулинорезистентности при разных формах неалкогольной жировой болезни печени // Медицинский совет. — 2023. — Т. 17. — №18. — С. 53-61. doi: https://doi.org/10.21518/ms2023-378Shipovskaya AA, Kurbatova IV, Larina NA, Dudanova OP. Comparative characteristics of the triglyceride-glucose index and the homeostatic index of insulin resistance in various forms of non-alcoholic fatty liver disease. Meditsinskiy sovet = Medical Council. 2023;(18):59-67. (In Russ.) doi: https://doi.org/10.21518/ms2023-378Волкова Н.И., Давиденко И.Ю., Сорокина Ю.А., и др. Методы оценки инсулинорезистентности при гестационном сахарном диабете. // Медицинский вестник Юга России. — 2022. — Т.13. — №1. — С.5-12. doi: https://doi.org/10.21886/2219-8075-2022-13-1-5-12Volkova NI, Davidenko IY, Sorokina YA, et al. Methods for assessing insulin resistance in gestational diabetes mellitus. Medical Herald of the South of Russia. 2022;13(1):5-12. (In Russ.) doi: https://doi.org/10.21886/2219-8075-2022-13-1-5-12Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 2016;86:99-105. doi: https://doi.org/10.1016/j.ypmed.2016.01.022Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 2016;86:99-105. doi: https://doi.org/10.1016/j.ypmed.2016.01.022Park B, Lee HS, Lee YJ. Triglyceride glucose (TyG) index as a predictor of incident type 2 diabetes among nonobese adults: a 12-year longitudinal study of the Korean Genome and Epidemiology Study cohort. Transl Res. 2021;228:42-51. doi: https://doi.org/10.1016/j.trsl.2020.08.003Park B, Lee HS, Lee YJ. Triglyceride glucose (TyG) index as a predictor of incident type 2 diabetes among nonobese adults: a 12-year longitudinal study of the Korean Genome and Epidemiology Study cohort. Transl Res. 2021;228:42-51. doi: https://doi.org/10.1016/j.trsl.2020.08.003Sendur SN, Isgin Atici K, Turan Demirci B, et al. The Triglycerides-Glucose Index Shows a Stronger Correlation with Serum Adiponectin Levels than Homeostasis Model Assessment of Insulin Resistance and Quantitative Insulin Sensitivity Check Index. Metab Syndr Relat Disord. 2023;21(7):410-414. doi: https://doi.org/10.1089/met.2023.0054Sendur SN, Isgin Atici K, Turan Demirci B, et al. The TriglyceridesGlucose Index Shows a Stronger Correlation with Serum Adiponectin Levels than Homeostasis Model Assessment of Insulin Resistance and Quantitative Insulin Sensitivity Check Index. Metab Syndr Relat Disord. 2023;21(7):410-414. doi: https://doi.org/10.1089/met.2023.0054Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Triglyceride-glucose index is a predictor of incident chronic kidney disease: a population-based longitudinal study. Clin Exp Nephrol. 2019;23(7):948-955. doi: https://doi.org/10.1007/s10157-019-01729-2Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Triglyceride-glucose index is a predictor of incident chronic kidney disease: a population-based longitudinal study. Clin Exp Nephrol. 2019;23(7):948-955. doi: https://doi.org/10.1007/s10157-019-01729-2Fritz J, Brozek W, Concin H, et al. The Triglyceride-Glucose Index and Obesity-Related Risk of End-Stage Kidney Disease in Austrian Adults. JAMA Netw Open. 2021;4(3):e212612. doi: https://doi.org/10.1001/jamanetworkopen.2021.2612Fritz J, Brozek W, Concin H, et al. The Triglyceride-Glucose Index and Obesity-Related Risk of End-Stage Kidney Disease in Austrian Adults. JAMA Netw Open. 2021;4(3):e212612. doi: https://doi.org/10.1001/jamanetworkopen.2021.2612Quiroga B, Muñoz Ramos P, Sánchez Horrillo A, et al. Triglyceridesglucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease. Clin Kidney J. 2022;15(9):1705-1712. doi: https://doi.org/10.1093/ckj/sfac073Quiroga B, Muñoz Ramos P, Sánchez Horrillo A, et al. Triglyceridesglucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease. Clin Kidney J. 2022;15(9):1705-1712. doi: https://doi.org/10.1093/ckj/sfac073Lim J, Kim J, Koo SH, Kwon GC. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey. PLoS One. 2019;14(3):e0212963. doi: https://doi.org/10.1371/journal.pone.0212963Lim J, Kim J, Koo SH, Kwon GC. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey. PLoS One. 2019;14(3):e0212963. doi: https://doi.org/10.1371/journal.pone.0212963Beran A, Ayesh H, Mhanna M, et al. Triglyceride-Glucose Index for Early Prediction of Nonalcoholic Fatty Liver Disease: A Meta-Analysis of 121,975 Individuals. J Clin Med. 2022;11(9):2666. doi: https://doi.org/10.3390/jcm11092666Beran A, Ayesh H, Mhanna M, et al. Triglyceride-Glucose Index for Early Prediction of Nonalcoholic Fatty Liver Disease: A MetaAnalysis of 121,975 Individuals. J Clin Med. 2022;11(9):2666. doi: https://doi.org/10.3390/jcm11092666De León DD, Stanley CA. Determination of insulin for the diagnosis of hyperinsulinemic hypoglycemia. Best Pract Res Clin Endocrinol Metab. 2013;27(6):763-769. doi: https://doi.org/10.1016/j.beem.2013.06.005De León DD, Stanley CA. Determination of insulin for the diagnosis of hyperinsulinemic hypoglycemia. Best Pract Res Clin Endocrinol Metab. 2013;27(6):763-769. doi: https://doi.org/10.1016/j.beem.2013.06.005Katz AI, Rubenstein AH. Metabolism of proinsulin, insulin, and C-peptide in the rat. J Clin Invest. 1973;52(5):1113-1121. doi: https://doi.org/10.1172/JCI107277Katz AI, Rubenstein AH. Metabolism of proinsulin, insulin, and C-peptide in the rat. J Clin Invest. 1973;52(5):1113-1121. doi: https://doi.org/10.1172/JCI107277Nishikage S, Hirota Y, Takayoshi T, et al. Utility of the C-Peptide/Insulin Molar Ratio for Distinguishing Type A Insulin Resistance Syndrome From Type 2 Diabetes. J Clin Endocrinol Metab. 2025;110(10):e3383-e3390. doi: https://doi.org/10.1210/clinem/dgaf043Nishikage S, Hirota Y, Takayoshi T, et al. Utility of the C-Peptide/Insulin Molar Ratio for Distinguishing Type A Insulin Resistance Syndrome From Type 2 Diabetes. J Clin Endocrinol Metab. 2025;110(10):e3383-e3390. doi: https://doi.org/10.1210/clinem/dgaf043Søndergaard E, Jensen MD. Quantification of adipose tissue insulin sensitivity. J Investig Med. 2016;64(5):989-991. doi: https://doi.org/10.1136/jim-2016-000098Søndergaard E, Jensen MD. Quantification of adipose tissue insulin sensitivity. J Investig Med. 2016;64(5):989-991. doi: https://doi.org/10.1136/jim-2016-000098Søndergaard E, Espinosa De Ycaza AE, Morgan-Bathke M, Jensen MD. How to Measure Adipose Tissue Insulin Sensitivity. J Clin Endocrinol Metab. 2017;102(4):1193-1199. doi: https://doi.org/10.1210/jc.2017-00047Søndergaard E, Espinosa De Ycaza AE, Morgan-Bathke M, Jensen MD. How to Measure Adipose Tissue Insulin Sensitivity. J Clin Endocrinol Metab. 2017;102(4):1193-1199. doi: https://doi.org/10.1210/jc.2017-00047Jorge-Galarza E, Posadas-Romero C, Torres-Tamayo M, et al. Insulin Resistance in Adipose Tissue but Not in Liver Is Associated with Aortic Valve Calcification. Dis Markers. 2016;2016:9085474. doi: https://doi.org/10.1155/2016/9085474Jorge-Galarza E, Posadas-Romero C, Torres-Tamayo M, et al. Insulin Resistance in Adipose Tissue but Not in Liver Is Associated with Aortic Valve Calcification. Dis Markers. 2016;2016:9085474. doi: https://doi.org/10.1155/2016/9085474Mu L, Li R, Lai Y, et al. Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome. J Endocrinol Invest. 2019;42(5):541-548. doi: https://doi.org/10.1007/s40618-018-0949-2Mu L, Li R, Lai Y, et al. Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome. J Endocrinol Invest. 2019;42(5):541-548. doi: https://doi.org/10.1007/s40618-018-0949-2Semnani-Azad Z, Connelly PW, Bazinet RP, et al. Adipose Tissue Insulin Resistance Is Longitudinally Associated With Adipose Tissue Dysfunction, Circulating Lipids, and Dysglycemia: The PROMISE Cohort. Diabetes Care. 2021;44(7):1682-1691. doi: https://doi.org/10.2337/dc20-1918Semnani-Azad Z, Connelly PW, Bazinet RP, et al. Adipose Tissue Insulin Resistance Is Longitudinally Associated With Adipose Tissue Dysfunction, Circulating Lipids, and Dysglycemia: The PROMISE Cohort. Diabetes Care. 2021;44(7):1682-1691. doi: https://doi.org/10.2337/dc20-1918Zhou Q, Yan H, Jin A, et al. Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke. Diabetol Metab Syndr. 2023;15(1):246. doi: https://doi.org/10.1186/s13098-023-01235-2Zhou Q, Yan H, Jin A, et al. Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke. Diabetol Metab Syndr. 2023;15(1):246. doi: https://doi.org/10.1186/s13098-023-01235-2Дедов И.И., Шестакова М.В., Сухарева О.Ю., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом / Под редакцией И.И. Дедова, М.В. Шестаковой, О.Ю. Сухаревой. 12-й выпуск // Сахарный диабет. — 2025. — Т. 28. — №5S. — С. 1-175. doi: https://doi.org/10.14341/DM20255SDedov I, Shestakova M, Sukhareva O, et al. 12th Edition. Diabetes mellitus. 2025;28(5S):1-175. (In Russ.) doi: https://doi.org/10.14341/DM20255SDavies MJ, Aroda VR, Collins BS, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925-1966. doi: https://doi.org/10.1007/s00125-022-05787-2Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925-1966. doi: https://doi.org/10.1007/s00125-022-05787-2Rossing P, Baeres FMM, Bakris G, et al. The rationale, design and baseline data of FLOW, a kidney outcomes trial with onceweekly semaglutide in people with type 2 diabetes and chronic kidney disease. Nephrol Dial Transplant. 2023;38(9):2041-2051. doi: https://doi.org/10.1093/ndt/gfad009Rossing P, Baeres FMM, Bakris G, et al. The rationale, design and baseline data of FLOW, a kidney outcomes trial with onceweekly semaglutide in people with type 2 diabetes and chronic kidney disease. Nephrol Dial Transplant. 2023;38(9):2041-2051. doi: https://doi.org/10.1093/ndt/gfad009Ibrahim SS, Ibrahim RS, Arabi B, Brockmueller A, Shakibaei M, Büsselberg D. The effect of GLP-1R agonists on the medical triad of obesity, diabetes, and cancer. Cancer Metastasis Rev. 2024;43(4):1297-1314. doi: https://doi.org/10.1007/s10555-024-10192-9Ibrahim SS, Ibrahim RS, Arabi B, Brockmueller A, Shakibaei M, Büsselberg D. The effect of GLP-1R agonists on the medical triad of obesity, diabetes, and cancer. Cancer Metastasis Rev. 2024;43(4):1297-1314. doi: https://doi.org/10.1007/s10555-024-10192-9Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2020;173(4):278-286. doi: https://doi.org/10.7326/M20-0864Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2020;173(4):278-286. doi: https://doi.org/10.7326/M20-0864Fruh SM. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract. 2017;29(S1):S3-S14. doi: https://doi.org/10.1002/2327-6924.12510Fruh SM. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract. 2017;29(S1):S3-S14. doi: https://doi.org/10.1002/2327-6924.12510Warkentin LM, Majumdar SR, Johnson JA, et al. Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: two-year prospective cohort study. BMC Med. 2014;12:175. doi: https://doi.org/10.1186/s12916-014-0175-5Warkentin LM, Majumdar SR, Johnson JA, et al. Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: two-year prospective cohort study. BMC Med. 2014;12:175. doi: https://doi.org/10.1186/s12916-014-0175-5Российская ассоциация эндокринологов, Общество бариатрических хирургов. Клинические рекомендации «Ожирение», 2024.Rossijskaya associaciya endokrinologov, Obshchestvo bariatricheskih hirurgov. Klinicheskie rekomendacii «Ozhirenie», 2024 (In Russ.)Tao LC, Xu JN, Wang TT, et al. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol. 2022;21(1):68. doi: https://doi.org/10.1186/s12933-022-01511-xTao LC, Xu JN, Wang TT, et al. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol. 2022;21(1):68. doi: https://doi.org/10.1186/s12933-022-01511-xWang X, Hansen BC, Shi D, et al. Quantification of β-cell insulin secretory function using a graded glucose infusion with C-peptide deconvolution in dysmetabolic, and diabetic cynomolgus monkeys. Diabetol Metab Syndr. 2013;5(1):40. doi: https://doi.org/10.1186/1758-5996-5-40Wang X, Hansen BC, Shi D, et al. Quantification of β-cell insulin secretory function using a graded glucose infusion with C-peptide deconvolution in dysmetabolic, and diabetic cynomolgus monkeys. Diabetol Metab Syndr. 2013;5(1):40. doi: https://doi.org/10.1186/1758-5996-5-40Stafeev I, Agareva M, Michurina S, et al. Semaglutide 6-months therapy of type 2 diabetes mellitus restores adipose progenitors potential to develop metabolically active adipocytes. Eur J Pharmacol. 2024;970:176476. doi: https://doi.org/10.1016/j.ejphar.2024.176476Stafeev I, Agareva M, Michurina S, et al. Semaglutide 6-months therapy of type 2 diabetes mellitus restores adipose progenitors potential to develop metabolically active adipocytes. Eur J Pharmacol. 2024;970:176476. doi: https://doi.org/10.1016/j.ejphar.2024.176476Ghusn W, Fansa S, Anazco D, et al. Weight loss and cardiovascular disease risk outcomes of semaglutide: a oneyear multicentered study. Int J Obes (Lond). 2024;48(5):662-667. doi: https://doi.org/10.1038/s41366-023-01456-5Ghusn W, Fansa S, Anazco D, et al. Weight loss and cardiovascular disease risk outcomes of semaglutide: a oneyear multicentered study. Int J Obes (Lond). 2024;48(5):662-667. doi: https://doi.org/10.1038/s41366-023-01456-5Zhu R, Chen S. Proteomic analysis reveals semaglutide impacts lipogenic protein expression in epididymal adipose tissue of obese mice. Front Endocrinol (Lausanne). 2023;14:1095432. doi: https://doi.org/10.3389/fendo.2023.1095432Zhu R, Chen S. Proteomic analysis reveals semaglutide impacts lipogenic protein expression in epididymal adipose tissue of obese mice. Front Endocrinol (Lausanne). 2023;14:1095432. doi: https://doi.org/10.3389/fendo.2023.1095432Vendrell J, El Bekay R, Peral B, et al. Study of the potential association of adipose tissue GLP-1 receptor with obesity and insulin resistance. Endocrinology. 2011;152(11):4072-4079. doi: https://doi.org/10.1210/en.2011-1070Vendrell J, El Bekay R, Peral B, et al. Study of the potential association of adipose tissue GLP-1 receptor with obesity and insulin resistance. Endocrinology. 2011;152(11):4072-4079. doi: https://doi.org/10.1210/en.2011-1070El Bekay R, Coín-Aragüez L, Fernández-García D, et al. Effects of glucagon-like peptide-1 on the differentiation and metabolism of human adipocytes. Br J Pharmacol. 2016;173(11):1820-1834. doi: https://doi.org/10.1111/bph.13481El Bekay R, Coín-Aragüez L, Fernández-García D, et al. Effects of glucagon-like peptide-1 on the differentiation and metabolism of human adipocytes. Br J Pharmacol. 2016;173(11):1820-1834. doi: https://doi.org/10.1111/bph.13481Gabery S, Salinas CG, Paulsen SJ, et al. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight. 2020;5(6):e133429. doi: https://doi.org/10.1172/jci.insight.133429Gabery S, Salinas CG, Paulsen SJ, et al. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight. 2020;5(6):e133429. doi: https://doi.org/10.1172/jci.insight.133429Niu S, Chen S, Chen X, et al. Semaglutide ameliorates metabolism and hepatic outcomes in an NAFLD mouse model. Front Endocrinol (Lausanne). 2022;13:1046130. doi: https://doi.org/10.3389/fendo.2022.1046130Niu S, Chen S, Chen X, et al. Semaglutide ameliorates metabolism and hepatic outcomes in an NAFLD mouse model. Front Endocrinol (Lausanne). 2022;13:1046130. doi: https://doi.org/10.3389/fendo.2022.1046130Kapitza C, Dahl K, Jacobsen JB, Axelsen MB, Flint A. Effects of semaglutide on beta cell function and glycaemic control in participants with type 2 diabetes: a randomised, double-blind, placebo-controlled trial. Diabetologia. 2017;60(8):1390-1399. doi: https://doi.org/10.1007/s00125-017-4289-0Kapitza C, Dahl K, Jacobsen JB, Axelsen MB, Flint A. Effects of semaglutide on beta cell function and glycaemic control in participants with type 2 diabetes: a randomised, double-blind, placebo-controlled trial. Diabetologia. 2017;60(8):1390-1399. doi: https://doi.org/10.1007/s00125-017-4289-0Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab. 2023;25(1):18-35. doi: https://doi.org/10.1111/dom.14863Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab. 2023;25(1):18-35. doi: https://doi.org/10.1111/dom.14863Ahmann AJ, Capehorn M, Charpentier G, et al. Efficacy and Safety of Once-Weekly Semaglutide Versus Exenatide ER in Subjects With Type 2 Diabetes (SUSTAIN 3): A 56-Week, Open-Label, Randomized Clinical Trial. Diabetes Care. 2018;41(2):258-266. doi: https://doi.org/10.2337/dc17-0417Ahmann AJ, Capehorn M, Charpentier G, et al. Efficacy and Safety of Once-Weekly Semaglutide Versus Exenatide ER in Subjects With Type 2 Diabetes (SUSTAIN 3): A 56-Week, Open-Label, Randomized Clinical Trial. Diabetes Care. 2018;41(2):258-266. doi: https://doi.org/10.2337/dc17-0417DeVries JH, Desouza C, Bellary S, et al. Achieving glycaemic control without weight gain, hypoglycaemia, or gastrointestinal adverse events in type 2 diabetes in the SUSTAIN clinical trial programme. Diabetes Obes Metab. 2018;20(10):2426-2434. doi: https://doi.org/10.1111/dom.13396DeVries JH, Desouza C, Bellary S, et al. Achieving glycaemic control without weight gain, hypoglycaemia, or gastrointestinal adverse events in type 2 diabetes in the SUSTAIN clinical trial programme. Diabetes Obes Metab. 2018;20(10):2426-2434. doi: https://doi.org/10.1111/dom.13396

The authors declare that there are no conflicts of interest present.