AbstractBackgroundComorbid type 2 diabetes mellitus (T2DM), severe obesity, and chronic myeloid leukemia (CML) present therapeutic challenges, especially given the limited data on glucagon-like peptide-1 (GLP-1) receptor agonists in this setting.MethodsWe describe a 33-year-old female with poorly controlled T2DM (HbA1c 10.7%), severe obesity (BMI 47.05 kg/m2), and stable CML on tyrosine kinase inhibitor therapy. She received once-weekly semaglutide (0.5–1.5 mg) for 6 months, alongside insulin glargine and dapagliflozin/metformin. Clinical, biochemical, and molecular parameters were monitored.ResultsAfter 6 months, her HbA1c declined from 10.7 to 5.5%, fasting plasma glucose from 16.2 to 5.3 mmol/L, and body weight decreased by 18 kg. Lipid parameters improved, and molecular analysis confirmed continued CML remission (undetectable BCR-ABL1). The patient experienced only mild, transient gastrointestinal side effects.ConclusionIn this complex case, semaglutide proved safe and effective for achieving glycemic control and weight reduction without compromising CML stability. These findings suggest that GLP-1 receptor agonists may be a viable therapeutic option for patients with coexisting T2DM, severe obesity, and stable CML, warranting further investigation in broader populations.