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- The prevalence of obesity and type 2 diabetes are both increasing rapidly.
- One common complication of these diseases is heart failure with preserved ejection fraction (HFpEF), a disease with poor prognosis and life-limiting symptoms.
- Currently, there are no effective treatments targeting obesity-associated HFpEF in patients with type 2 diabetes.
- A new study suggests that semaglutide (Wegovy), commonly used for weight loss, may reduce symptoms of heart failure in people with both type 2 diabetes and obesity.
As the prevalence of obesity increases around the world, the need for effective treatments for related health conditions becomes more urgent.
In the United States, more than
The most common forms of heart failure in patients with obesity and type 2 diabetes are:
Despite the prevalence of HFpEF, currently
Now, according to research,
This study New England Medical Journal.
Richard Wright, M.D., a board-certified cardiologist at Providence St. John’s Health Center in Santa Monica, Calif., who was not involved in the study, commented on the following trial results. Today’s medical news. He told us:
“This is an important exam that reinforces concepts such as: [symptoms] The administration of drugs that were originally developed to lower blood sugar levels and are now emerging as an important way to reduce cardiovascular disease and heart failure events while improving patients’ functional capacity and sense of well-being are improving the symptoms of heart failure syndrome. You can further benefit from improvements. ”
It also promotes weight loss.
Studies have shown that it may also reduce cardiovascular risk in obese people. One previous trial found that 1 year of treatment with semaglutide significantly reduced the 10-year risk of developing the disease.
In March 2024,
Researchers found that the drug in people with HFpEF, obesity, and type 2 diabetes follows a recent study that found that semaglutide reduces symptoms and physical limitations and improves motor function in people with HFpEF, obesity, and type 2 diabetes. decided to test it.
Researchers running the current trial recruited 616 participants at 108 sites in 16 countries. All participants had HFpEF, body mass index (BMI) >30, and type 2 diabetes. Researchers randomly assigned patients to receive weekly injections of semaglutide (2.4 milligrams) or a placebo for 52 weeks.
All participants were taking other medications, including diuretics and renin-angiotensin system blockers.
The study had two primary endpoints: change in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) and percent change in weight from baseline to week 52.
In addition, the researchers established secondary endpoints of change in 6-minute walking distance and log-transformed change.
The semaglutide group had a greater reduction in heart failure symptoms, with an average improvement of 13.7 points on the KCCQ-CSS compared to 6.4 points in the placebo group.
They also lost more weight than the placebo group, with an average weight loss of 9.8% in the treatment group and 3.4% in the placebo group, and CRP levels decreased by 42% compared to 12.8% in the placebo group.
As Professor Wright explained, the treatment group lost 40% less weight than participants in a previous trial of patients with heart failure and obesity who did not have type 2 diabetes, but they still saw improvement in symptoms. It is said that MNT:
“Semaglutide was expected to lead to weight loss” [in] These obese patients. However, although weight loss with the drug in this trial was quite modest, heart failure patients with preserved ejection fraction showed clinically significant improvements in quality of life, measures of functional capacity, and NT proBNP. and a decrease in important biomarkers such as CRP and numerically. Possible heart failure decompensation. ”
In the published paper, researchers hypothesize that the weight loss-independent benefits of semaglutide in HFpEF “may include direct effects on decongestion.” Blood vessel, skeletal muscle, and mitochondrial function. Epicardial adipose tissue. Inflammation; that factor may be more pronounced in people with type 2 diabetes (unlike weight loss) than in people without type 2 diabetes. ”
However, Dr. Wright commented:[t]The exact mechanisms of these improvements are still subject to speculation, but they do not appear to be purely related to weight loss. ”
“Certainly,” he added, “many of the effects in these heart failure patients appear to occur before significant weight loss, suggesting that GLP-1 receptor agonists can improve metabolic syndrome and ‘heart failure.’ The syndromes that strongly suggest that they are connected are independent and perhaps in addition to what would be expected from weight loss. ”
Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, who was not involved in the study, welcomed the results.
“Based on this study, the use of semaglutide may be beneficial in obese diabetic patients with heart failure,” he told us.
But, he added, “studies comparing semaglutide to other drugs to treat diabetes and heart failure would be useful.”
Mr Wright said:[i]The basic treatment for obese patients with type 2 diabetes now consists of SGLT2 inhibitors and GLP-1 receptor agonists, rather than the historic and perhaps now somewhat outdated treatment of metformin and insulin. It seems that it should be administered in combination. ”
Although it remains to be seen whether their optimism is justified, this study suggests that semaglutide may be an effective treatment for diabetes-associated heart failure.
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