Posted on Aug 10, 2019, 3 p.m.
Hormone treatment may help those with obesity experience some of the benefits associated with gastric bypass without having to have the surgery, according to recent research.
Effects of daily GOP hormone infusions were examined in 15 participants with obesity and type 2 diabetes or prediabetes for 4 weeks; infusions lasted for 12 hours per day and contained 3 gut hormones, of which the levels increase in those who undergo gastric bypass surgery. The hormone combination is called GOP, short for glucagon-like peptide 1, oxyntomodulin, and peptide YY.
Those who received the GOP treatment experienced near normal glucose levels without large swings in glucose and insulin; infusions were feasible and well tolerated, according to a report published in Diabetes Care. The infusions resulted in a mean weight loss of 4.4kg, and 11 control participants receiving saline solution infusions lost 2.5kg on average.
Infusions were administered at home by the participants following instructions to connect a portable infusion pump 1 hour before breakfast and disconnect it 12 hours later after their last meal of the day; both the control and treatment groups received counseling on diet, healthy eating, and weight loss, as well as stopped their usual diabetes treatments during the trial.
Obesity increases the risk for developing a number of conditions such as type 2 diabetes, stroke, heart disease, and some cancers. According to W.H.O rates of obesity and excess weight are increasing around the globe, obesity is estimated to affect 39.8% of adults in America alone. Gastric bypass surgery can help those with obesity to lose excess weight and those with type 2 diabetes to improve blood sugar levels, but not all patients qualify for this surgery. Gastric bypass surgery can result in complications such as stomach pain, persistent vomiting, nausea, and low blood sugar levels.
Research suggests that increases in GOP hormones may be behind the success of gastric bypass surgery; after surgery the small intestine and colon appear to produce more GOP hormones which can spur weight loss, suppress appetite, and improve the ability of cells to take in and use sugar from digested food.
Prof. Tan concludes that "Although this is a small study, our new combination hormone treatment is promising and has shown significant improvements in patients' health in only 4 weeks."
Additionally 43 other participants were randomly assigned to GOP hormone and saline groups which were monitored for glucose levels and weight loss; 21 participants underwent gastric bypass surgery and 22 followed a low calorie diet. Those on the low calorie diet or had surgery lost more weight than those who received GOP therapy; average weight loss was 10.3kg in the surgery group, and 8.3kg in the low calorie diet group but GOP infusions seemed to have more of a beneficial effect on blood glucose. Those who had surgery achieved improvements in blood sugar but glucose levels had larger highs and lows. Those in the GOP group experienced near normal blood sugar with less variables.
According to the researchers non-invasive GOP infusion appears to carry fewer side effects, although it may result in less weight loss. The researchers are planning a larger trial with longer duration.
"This study adds to emerging evidence of the potential benefit of future medications that are a combination of gut hormones for the treatment of obesity," comments Professor Lora Heisler, Chair in Human Nutrition at the Rowett Institute of the University of Aberdeen, who was not involved in the study.
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