Ashok A. Ganeshalingam

What is the title of your thesis?

From metabolic vulnerability to therapeutic opportunity: targeted treatment of cardiovascular risk in schizophrenia – results from the HISTORI study.

At which department and/or research unit did you complete your PhD?

Department of Endocrinology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark – in collaboration with Steno Diabetes Center Odense and the psychiatry services in the Region of Southern Denmark and Region Zealand.

Who was your principal supervisor?

Professor Jan Frystyk, MD, PhD, DMSc.

What question did you aim to answer with your thesis?

People with schizophrenia live, on average, 15–20 years fewer than the general population. A large part of this difference is due to obesity, prediabetes and cardiovascular disease, which are often exacerbated by the medication used to treat psychiatric symptoms.

I wanted to investigate whether the medication semaglutide – normally used to treat diabetes and obesity – can also improve blood sugar levels and reduce cardiovascular risk in people with schizophrenia.

What did you find?

My PhD project is based on the HISTORI study, a Danish, double-blind, placebo-controlled trial involving 154 patients living with schizophrenia, prediabetes and obesity.

Participants received either semaglutide or a placebo for 30 weeks – as a home-based treatment, with research nurses visiting participants to collect samples and monitor their health.

How did you do it?

After 30 weeks of treatment with semaglutide:

• Blood sugar levels decreased significantly (HbA1c).
• Patients lost more than 9 kilograms on average.
• Cholesterol levels and insulin sensitivity improved.
• Physical quality of life increased, without any worsening of psychiatric symptoms.
• No serious side effects were observed, and semaglutide was generally well tolerated.

How can your research be applied (in the clinic, society, etc.)?

The results show that semaglutide can be used to prevent diabetes and cardiovascular disease in patients with schizophrenia – a group that often falls between the cracks in the healthcare system.

The study indicates that close collaboration between psychiatry and endocrinology can improve blood sugar levels, physical quality of life and overall health in people living with schizophrenia.

In addition, the study highlights the considerable potential of home-based treatments. The knowledge generated can be used to ensure better care for people living with schizophrenia who are at increased risk of cardiovascular disease.