Type 2 diabetes and obesity represent a major public health challenge. This thesis aims to analyze the pharmacological mechanisms underlying the effects of semaglutide, a drug proven effective in the treatment of both conditions. Semaglutide works by mimicking the action of endogenous GLP-1, an incretin involved in regulating glycemic homeostasis and inducing feelings of satiety. Semaglutide is currently available as an oral formulation (for the treatment of type 2 diabetes only) and as a subcutaneous injectable formulation. However, the innovation process associated with semaglutide is still constantly evolving: for this reason, a second objective of this work is to describe new formulations under study and to explore a series of additional beneficial effects observed for semaglutide in the cardiovascular, renal, and hepatic fields. Alongside its clinical benefit, semaglutide is also associated with a series of adverse events, which can arise either during use within authorized therapeutic indications or during off-label uses or improper uses. Despite the existence of precise prescriptive methods for various pharmaceutical specialties containing semaglutide, many individuals obtain the active ingredient from fraudulent websites, often prompted by reading misleading content on various social media. For this reason, the final part of the paper describes the worrying dynamics associated with semaglutide on social media platforms. Indeed, online searches for the specialty Ozempic have increased in recent years: although this semaglutide-based medicinal specialty is licensed for type 2 treatment, it is frequently promoted on social media, mainly by private users and influencers, for its ability to promote weight loss. This results in a simplified representation of the active ingredient, inconsistent with available scientific evidence; consequently, this phenomenon can promote risky behaviors, including the online purchase without a prescription of counterfeit medicines that do not meet quality, safety, and efficacy standards. Considering these critical issues, an increase in online health education is necessary to help users make more informed choices.
Il diabete di tipo 2 e l’obesità rappresentano una delle principali sfide che la salute pubblica deve affrontare. Questa tesi si propone di analizzare i meccanismi farmacologici alla base degli effetti di semaglutide, farmaco dimostratosi efficace nel trattamento di entrambe le condizioni. Semaglutide agisce mimando l’azione del GLP-1 endogeno, un’incretina coinvolta nella regolazione dell’omeostasi glicemica e nell’induzione della sensazione di sazietà. Attualmente semaglutide è disponibile in formulazione orale (solo per il trattamento del diabete di tipo 2) e in formulazione iniettabile sottocutanea. Il processo di innovazione legato a semaglutide è però ancora in continua evoluzione: per tale motivo, un secondo obiettivo di questo elaborato è rappresentato dal descrivere nuove formulazioni in studio e dall’approfondire una serie di effetti aggiuntivi benefici osservati per semaglutide nell’ambito cardiovascolare, renale ed epatico. Accanto al beneficio clinico, semaglutide è tuttavia associata anche ad una serie di eventi avversi, che possono insorgere sia durante l’impiego all’interno delle indicazioni terapeutiche autorizzate, sia durante usi off- label o usi impropri. Nonostante l’esistenza di precise modalità prescrittive delle varie specialità farmaceutiche contenenti semaglutide, molti soggetti si procurano il principio attivo da siti web fraudolenti, spesso spinti dalla lettura di contenuti fuorvianti sui diversi social media. Per questo motivo, la parte finale dell’elaborato descrive le dinamiche preoccupanti associate a semaglutide sulle piattaforme social. In effetti, le ricerche online relative alla specialità Ozempic sono aumentate negli ultimi anni: nonostante questa specialità medicinale a base di semaglutide sia autorizzata per il trattamento di tipo 2, sui social media essa viene frequentemente promossa, prevalentemente da utenti privati ed influencer, per la sua capacità di favorire la perdita di peso. Ciò comporta una rappresentazione semplificata del principio attivo, non coerente con le evidenze scientifiche disponibili; di conseguenza, tale fenomeno può favorire comportamenti rischiosi, tra cui l’acquisto online senza prescrizione di medicinali contraffatti e non conformi agli standard di qualità, sicurezza ed efficacia. Alla luce di queste criticità si rende necessario un incremento dell’educazione sanitaria online, al fine di aiutare gli utilizzatori a prendere scelte più consapevoli.
Semaglutide: farmacologia e realtà clinica all’interno del mito contemporaneo.
LA MONICA, ALESSIA
2025/2026
Abstract
Type 2 diabetes and obesity represent a major public health challenge. This thesis aims to analyze the pharmacological mechanisms underlying the effects of semaglutide, a drug proven effective in the treatment of both conditions. Semaglutide works by mimicking the action of endogenous GLP-1, an incretin involved in regulating glycemic homeostasis and inducing feelings of satiety. Semaglutide is currently available as an oral formulation (for the treatment of type 2 diabetes only) and as a subcutaneous injectable formulation. However, the innovation process associated with semaglutide is still constantly evolving: for this reason, a second objective of this work is to describe new formulations under study and to explore a series of additional beneficial effects observed for semaglutide in the cardiovascular, renal, and hepatic fields. Alongside its clinical benefit, semaglutide is also associated with a series of adverse events, which can arise either during use within authorized therapeutic indications or during off-label uses or improper uses. Despite the existence of precise prescriptive methods for various pharmaceutical specialties containing semaglutide, many individuals obtain the active ingredient from fraudulent websites, often prompted by reading misleading content on various social media. For this reason, the final part of the paper describes the worrying dynamics associated with semaglutide on social media platforms. Indeed, online searches for the specialty Ozempic have increased in recent years: although this semaglutide-based medicinal specialty is licensed for type 2 treatment, it is frequently promoted on social media, mainly by private users and influencers, for its ability to promote weight loss. This results in a simplified representation of the active ingredient, inconsistent with available scientific evidence; consequently, this phenomenon can promote risky behaviors, including the online purchase without a prescription of counterfeit medicines that do not meet quality, safety, and efficacy standards. Considering these critical issues, an increase in online health education is necessary to help users make more informed choices.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.14239/36201