COMMETS- Combination MCI Metabolic Syndrome

Inclusion Criteria: * Diagnosis of MCI (based on a MOCA \<27 and a clinical dementia rating scale \[CDR\] score of 0.5 representing questionable dementia). * Diagnosis of MetS -requiring a) abdominal obesity (waist circumference \>102cm for men and \>88cm for women), and b) glucose intolerance (fasting glucose\>110 mg/dL) and at least one of the following-c) dyslipidemia (high triglycerides \[\>150 mg/dL\] and low HDL \[\<40mg/dL for men and \<50 mg/dL for women\]), or d) elevated blood pressure (\>130/\>85 mmHg). * Fluent in Hebrew * The study requires an active study partner Exclusion Criteria: * Diabetes (of any type) * Taking medications that may affect glucose metabolism (including a GLP-1RA). * Diagnosis of dementia and its subtypes, conditions that may directly affect cognition, * short life expectancy or a medical condition that precludes consistent participation in the study, * contraindications to either insulin or Semaglutide. * Medications that may affect glucose metabolism such as corticosteroids.