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Hormone Therapy Helps Weight Loss In Obese Patients With Diabetes

A new hormone injection may aid weight loss in obese patients with diabetes, possibly giving patients an alternative to gastric bypass surgery, a common weight-loss surgery to keep excess weight off and improve blood sugar levels in diabetics.

The findings came from a small study in which patients lost on average 4.4kg and the treatment led to substantial improvements to their blood glucose, with some patients’ reducing to near-normal levels.

Previous research by Imperial College London suggested that one of the reasons why gastric bypass surgery works so well is because three specific hormones originating from the bowels are released at higher levels.

This hormone combination, called ‘GOP’ for short, reduces appetite, causes weight loss and improves the body’s ability to use the sugar absorbed from eating.

How Was The Study Conducted?

Researchers wanted to see if infusing patients with the GOP hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin and peptide, to mimic the high levels seen after surgery, could aid weight loss and reduce high glucose levels.

Twenty-six obese patients with prediabetes and those with diabetes were recruited to the study at Hammersmith Hospital from July 2016 to October 2018.

Fifteen patients were randomly selected to receive the hormone treatment and 11 patients were given a saline infusion as a placebo over a four-week period.

The team also recruited 21 patients who had undergone bariatric surgery and 22 patients who followed a very-low-calorie diet to compare the results of GOP.

All patients were given a glucose monitoring device to track their glucose levels following treatment.

Patients also received dietetic advice on healthy eating and weight loss from a dietician.

What Were The Findings?

In the trial, patients on the GOP treatment lost an average of 4.4kg, compared with 2.5kg for participants receiving a saline placebo. The treatment also had no side effects.

However, patients who received bariatric surgery or who followed a very-low-calorie diet lost significantly more weight than GOP patients.

The changes in weight were 10.3kg for the bariatric patients and 8.3kg for patients who followed a very low-calorie diet.

“Although the weight loss was smaller, using the GOP infusion would be preferable as it has fewer side effects than bariatric surgery,” commented Tricia Tan, professor of metabolic medicine & endocrinology at Imperial College London and lead author of the study.

“This result shows that it is possible to obtain some of the benefits of a gastric bypass operation without undergoing the surgery itself. If further trials are successful, in future we could potentially give this type of treatment to many more patients,” she said.

The team also found that GOP was capable of lowering blood glucose levels to near-normal levels, with little variation in the blood glucose.

Patients who received bariatric surgery also had an overall improvement in blood glucose, but the levels were much more variable, leaving them vulnerable to low blood glucose levels.

“Although this is a small study our new combination hormone treatment is promising and has shown significant improvements in patients’ health in only four weeks,” Tan said. “Compared to other methods the treatment is non-invasive and reduced glucose levels to near-normal levels in our patients.”

The team plans to carry out a larger clinical trial to assess the impact of GOP on more patients over a longer period of time.

The research was funded by the UK Medical Research Council (MRC) and the NIHR Imperial Biomedical Research Center.

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