In recent years, many medical studies and programs have been aimed at the multifactorial treatment of type 2 diabetes mellitus (DM2), which not only includes achieving target blood glucose values, but also has cardio-nephroprotective properties to reduce the risk of remote macro- and microvascular complications, and also has a positive effect on body weight. A significant breakthrough in the solution of DM2 control and management was the fundamental discovery of a new class of hypoglycemic drugs: prolonged and highly homologous of glucagon-like peptide-1 receptor agonists (GLP-1 RA) – semaglutide, based on this class of the generally recognized drug liraglutide. This article provides 2 clinical examples of the use of domestic semaglutide (Semavik). The first clinical case describes a 62-year-old patient with grade 3 abdominal-constitutional obesity, a long history of DM2, receiving combination therapy (insulin glargine + sodium glucose cotransporter inhibitor type 2 + metformin). The second clinical case presents a patient with newly diagnosed type 2 diabetes and obesity, for whom therapy with domestic GLP-1RA as first-line therapy was initiated. The patients underwent an examination that allowed the use of GLP-1 RA, the dynamics of blood glucose normalization, improvement of lipid profile indicators, and weight loss were shown. These clinical cases are an example of the possibility of using modern drugs, in particular, domestic semaglutide as monotherapy and combination therapy with subsequent insulin withdrawal. The use of modern drugs allows to achieve target glycemic indicators, prevent the development of cardiovascular complications and improve life prognosis in a greater number of cases.

Keywords: semaglutide, glucagon-like peptide-1 receptor agonists, diabetes mellitus, glucose, obesity