Grant: Doctoral Research Award: Canada Graduate Scholarships

Semaglutide is a medication developed to help people living with type 2 diabetes (T2D) better manage their blood sugar levels, and help people living with obesity lose weight. In large clinical trials, semaglutide was shown to reduce the risk of heart attack, stroke, or death from heart-related causes. Semaglutide was also shown to improve their quality of life and exercise capacity in people living with heart failure and obesity. However, researchers do not yet fully understand how semaglutide protects the heart. The investigators previously discovered a special population of cells involved in repairing blood vessels known as vascular regenerative (VR) cells. People with T2D had less VR cells in their blood compared to people without T2D. VR cells increased after taking a medication named empagliflozin which is known to reduce blood sugar levels and heart failure risk. VR cells also increased after bariatric surgery, a procedure that drastically reduces body weight and helps reverse diabetes. However, whether the quantity of VR cells can be improved with semaglutide is unknown. The investigators designed a clinical trial involving 100 individuals living with T2D or obesity. Half of the participants will be allocated to receive semaglutide once-weekly for 6 months, and the other half will receive usual care. From each participant, a blood sample of up to 50mL will be drawn at baseline and at 6 months, to measure changes in: - The quantity of VR cells in blood - The vessel-repairing function of VR cells in cell culture and in animals with heart disease - The expression of genes and proteins involved in vessel repair The investigators hypothesize that over 6 months, individuals receiving weekly semaglutide will show greater improvements in VR cell quantity and function, and express more vessel-repairing genes and proteins compared to individuals receiving usual care. This trial will help researchers better understand how semaglutide protects the heart.