Hormonal
Post-myocardial infarction patients with overweight/obesity and high-risk prediabetes (HbA1c 6.0-6.4%) face a 54% five-year risk of progressing to type 2 diabetes, making them the highest-priority candidates for semaglutide treatment.
If you have had a heart attack and are overweight, getting your HbA1c checked is critical. If it is between 6.0% and 6.4%, your risk of developing full-blown diabetes within five years is over 50%. For this specific group, treatment with semaglutide (2.4 mg weekly) is highly efficient at preventing diabetes, with fewer than three people needing treatment to save one from diabetes. This makes it a priority intervention for this subgroup.
The 5-year risks of progression to type 2 diabetes were 54%, 30%, and 5%, respectively. Compared with normoglycemia, those with prediabetes6.0−6.4% were associated with an 18-fold increased risk of progression to type 2 diabetes (HR 18.3, 95% CI 15.2–22.1)
Why this rating
Large real-world cohort (n=7398) with long follow-up, though NNT is estimated from a trial rather than directly observed.
Source
Progression to type 2 diabetes among post–myocardial infarction patients with overweight or obesity: a real-world cohort study
Pernille Tilma Tonnesen et al. · Cardiovascular Diabetology · 2026
DOI 10.1186/s12933-026-03085-4
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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