Semaglutide 1.0 mg weekly for 30 weeks reduced fasting glucose by 0.87 mmol/L, improved insulin sensitivity (8.60), lowered insulin resistance (−0.69), and caused 9.2 kg weight loss in patients with s
Does semaglutide 1.0 mg weekly improve insulin sensitivity and β-cell function in overweight or obese patients with schizophrenia and prediabetes on second-generation antipsychotics?
Semaglutide 1.0 mg weekly significantly improves insulin sensitivity and reduces insulin resistance, partly mediated by weight loss, in patients with schizophrenia, prediabetes, and obesity on second-generation antipsychotics.
Tasa de eventos absoluta: 0% vs 0%
OBJECTIVE To examine the effects of semaglutide on insulin sensitivity, insulin resistance, and β-cell function and explore whether these changes were mediated by weight loss in overweight or obese individuals with schizophrenia and prediabetes receiving second-generation antipsychotics. RESEARCH DESIGN AND METHODS In this 30-week, double-blind trial, 154 participants were randomized to semaglutide (n = 77) or placebo (n = 77); 141 (91.5%) completed the study. Baseline and end-of-study assessments included fasting glucose, insulin, C-peptide, HOMA2 of β-cell function, HOMA2 of insulin sensitivity, HOMA of insulin resistance, and body weight. RESULTS Participants (56% women, mean age 38.3 years) provided complete insulin data in 131 cases. Compared with placebo, semaglutide significantly reduced fasting glucose (−0.87 mmol/L 95% CI −1.15, −0.59; P 0.001), improved insulin sensitivity (8.60 5.82, 13.65; P = 0.001), and lowered insulin resistance (−0.69 −1.00, −0.20; P = 0.006). Mean weight loss was 9.2 kg and mediated improvements in insulin sensitivity (estimate 7.82; P = 0.01) and insulin resistance (estimate −0.75; P = 0.01). Nonsignificant trends were observed toward reduced fasting insulin (−52.3 pmol/L; P = 0.11) and C-peptide (−182.9 pmol/L; P = 0.096), with a modest, nonsignificant increase in β-cell function (8.10; P = 0.19). CONCLUSIONS Semaglutide significantly improved insulin sensitivity, reduced insulin resistance, lowered fasting glucose, and promoted substantial weight loss in patients with antipsychotic-induced metabolic disturbances. Weight loss partly mediated the metabolic improvements, while β-cell function remained largely unchanged. These findings support semaglutide as a potential strategy for mitigating metabolic dysfunction in this high-risk population.
Ganeshalingam et al. (Wed,) reported a other. Semaglutide 1.0 mg weekly for 30 weeks reduced fasting glucose by 0.87 mmol/L, improved insulin sensitivity (8.60), lowered insulin resistance (−0.69), and caused 9.2 kg weight loss in patients with s.