Medical scientists and researchers from Imperial College London have developed a new hormone-based protocol that can help patients with diabetes and obesity loose body weight (as much as between 4.5 to 6 kilos) within a period of 4 weeks without much efforts. The treatment also leads to substantial improvements in the blood glucose of the patients with most reverting back to normal levels.
Obesity is a growing problem in the West and countries like the US, Britain, Australia and Germany have as an average about 1 out of 4 individuals who are obese. The problem is also starting to manifest in Asia in countries like China, Singapore, Malaysia and even Thailand with rising bad dietary habits people are emulating from the west including processed foods. One of the most common types of weight loss surgery is a procedure known as gastric bypass surgery, which can be very effective in keeping excess weight off and improving blood sugar levels in diabetics. However, some patients decide against the major surgery as the procedure can cause complications such as abdominal pain, chronic nausea, vomiting and debilitating low blood sugar levels.
The researchers previously found that one of the reasons why gastric bypass surgery worked so well is because three specific hormones originating from the bowels are released in higher levels after the surgery. This triple hormone combination, called "GOP' for short, reduces appetite, causes weight loss and improves the body's ability to use the sugar absorbed from eating.
The team from Imperial College tested to see if infusing patients with the GOP hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin and peptide YY, to mimic the high levels seen after surgery, could aid weight loss and reduce high glucose levels.
The study involved fifteen obese and diabetic candidates who were given were the GOP treatment for four weeks using a pump that slowly injects the GOP mixture under the skin for 12 hours a day, one hour before breakfast and disconnecting after their last meal of the day.
"Type 2 diabetes and obesity can lead to very serious and dangerous life-threatening conditions such as cancer, stroke and heart disease. There is a real need to find new drugs to improve and save the lives of many patients. 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. Compared to other methods the treatment is non-invasive and reduced glucose levels to near-normal levels in our patients." commented lead author, Professor Dr Tricia Tan, (Metabolic Medicine & Endocrinology) at Imperial College London in an exclusive interview with Thailand Medical News.
In second trial with Imperial College of London, twenty-six obese patients with prediabetes (when blood glucose is too high but not high enough to be classified as diabetes) and those with diabetes were recruited to the study at Hammersmith Hospital. Fifteen patients were randomly selected to receive the hormone treatment and 11 patients were given a saline infusion as a placebo over a 28 day 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. In the trial, patients on the GOP treatment lost an average of 4.4kg, 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 bariatric patient and 8.3kg for patients who followed a very low calorie diet.
Although the weight loss was smaller, using the GOP infusion was more advantageous as it has fewer side effects than bariatric surgery. The result shows that it is possible to obtain some of the benefits of a gastric bypass operation without undergoing the surgery itself .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.
The team aim to carry out a larger clinical trial to assess the impact of GOP on more patients over a longer period of time.
The new hormone based protocol will be submitted for regulatory approvals and will only be allowed to be administered by doctors.
Reference: Preeshila Behary et al. Combined GLP-1, Oxyntomodulin, and Peptide YY Improves Body Weight and Glycemia in Obesity and Prediabetes/Type 2 Diabetes: A Randomized, Single-Blinded, Placebo-Controlled Study, Diabetes Care (2019). DOI: 10.2337/dc19-0449