Omega-3 fatty acids are natural fats found in foods such as oily fish and flaxseed. Omega-3 fatty acids have been found to have positive effects on cardiovascular health, but there is less evidence on if they can help manage blood glucose in individuals with both cardiovascular disease and type 2 diabetes.

This study will investigate whether the beneficial effects found in omega-3 fatty acids such as lowered blood glucose and reduced inflammation - both of which are important for managing type 2 diabetes and cardiovascular disease, can be beneficial for individuals with type 2 diabetes. As omega-3 fatty acids are already found naturally in food, and are already available as supplements, they could be a safe option to help manage these diseases.

The aim of this study is to investigate if omega-3 fatty acids can slow down the progression of type 2 diabetes and reduce the risk of cardiovascular disease in individuals with type 2 diabetes.

Inclusion Criteria:

• Individuals who are over 18 years of age with a BMI between 25-50 kg/m2, and who have been diagnosed with T2DM (>7.0 mmol/l fasting glucose) or pre-diabetes (impaired glucose tolerant 5.0-6.9mmol/l) and are either on no medication, are diet controlled or taking metformin. Participants may also have a history of cardiovascular disease.

Exclusion Criteria:

• Those who have severe or unstable cardiovascular disease
• Type 2 diabetics or prediabetics who are on an anti-diabetic medication (with the exception of metformin)
• Undergone recent major surgery or planned surgery during the study period
• Have implanted devices (such as pacemakers or defibrillators)
• Have an active infection
• Are involved in any other type of weight loss study/intervention
• Are pregnant/breastfeeding.

Participants receiving Semaglutide will be aware of treatment allocation due to the nature of administration, while participants receiving omega-3 supplementation or placebo will remain blinded.