With the continuous improvement of people’s living standards, lifestyle changes and environmental factors, the incidence of metabolic disorders such as obesity and diabetes is constantly increasing. Obesity is a chronic, progressive and relapsing disease associated with reduced life expectancy and disability, depending on its duration, the magnitude of excess weight and the development of complications [30]. Obesity is a significant risk factor for type 2 diabetes (T2D) and is responsible for approximately 43% of all T2D cases, reaching 80–85% in some populations [31]. More than 90% of people with T2D are also overweight or obese, and more than 20% of people with obesity also have type 2 diabetes. The global prevalence of obesity and diabetes has been steadily increasing in recent decades. The number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014, with an estimated increase to 643 million by 2030 and 783 million by 2045 [32].
Lifestyle modification, particularly recommendations to follow an appropriate dietary pattern, has been generally accepted as a cornerstone of treatment for people with obesity and type 2 diabetes, with the expectation that adequate energy and nutrient intake will reduce body weight, improve glycemic control, and reduce the risk of complications.
In this regard, emerging drugs in the class of glucagon-like peptide-1 receptor antagonists (GLP-1RAs), which belong to the incretin-based therapies, are currently approved for the treatment of type 2 diabetes (T2DM) and obesity. These are being carefully reviewed, given their beneficial impact on glycemic control, their ability to reduce visceral adipose tissue and total body weight, and their cardio-reno-metabolic benefits in patients with T2DM and obesity. Among the GLP-1 receptor agonists currently available for the treatment of diabetes, semaglutide 1.0 mg has demonstrated the greatest weight loss effect in patients with T2DM.
We will investigate the extent to which intensive diet and physical activity interventions will improve body weight, body composition, anthropometric parameters, functioning, metabolic and glycemic control in people with obesity and type 2 diabetes, when used in combination with semaglutide treatment.