2nd Edition of International Obesity and Metabolism Conference 2026

Abstract

Background:
Obesity, diabetes, and heart failure with preserved ejection fraction (HFpEF) represent a complex cardiometabolic continuum that often overlaps with respiratory dysfunction such as obstructive sleep apnoea (OSA). The introduction of oral glucagon-like peptide-1 receptor agonists (GLP-1 RA) has provided a new paradigm for holistic disease modification beyond glucose lowering.

Case Presentation:
A 41-year-old male government officer (BMI 33 kg/m²; weight 100 kg) with a history of HFpEF, stage 3B chronic kidney disease secondary to diabetic nephropathy, uncontrolled type 2 diabetes mellitus (HbA1c 12%), dyslipidaemia, hypertension, and severe OSA on CPAP presented with reduced effort tolerance (NYHA II–III) and poor quality of life. After structured counselling at the obesity clinic, oral semaglutide 3 mg once daily was introduced alongside existing insulin and metformin XR 1000 mg.

Results:
After five months of therapy, the patient achieved an 8 kg weight reduction (BMI 33.5 → 30.0), HbA1c improvement from 12% → 6.9%, and better lipid control (TC 3.4 mmol/L, LDL 1.98 mmol/L, TG 0.93 mmol/L). Albumin-creatinine ratio improved from 329 → 295 mg/g, indicating renal stabilization. His oxygen saturation increased from 85–88% RA → 94–96% RA, allowing successful CPAP weaning. The patient reported marked improvement in daily functionality and overall well-being.

Conclusion:
Oral semaglutide produced multidimensional health gains — achieving glycaemic normalization, renal stability, respiratory recovery, and weight improvement. This case underscores the potential of GLP-1 receptor agonist therapy to restore cardiometabolic harmony in complex obesity-related multisystem disease and supports integrating pharmacotherapy within comprehensive obesity management frameworks.