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.
Obesity is a common problem in the UK and it is estimated that one in four adults are obese.
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 surgery and the procedure can cause complications such as abdominal pain, chronic nausea, vomiting and debilitating low blood sugar 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 in 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.
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.
Fifteen patients were given the GOP treatment for four weeks using a pump that slowly injects the GOP mixture under the skin for 12 hours a day, beginning one hour before breakfast and disconnecting after their last meal of the day. Patients also received dietetic advice on healthy eating and weight loss from a dietician.
Professor Tricia Tan, Professor of Practice (Metabolic Medicine & Endocrinology) at Imperial College London and lead author of the study, said:
"Obesity and type 2 diabetes can lead to very serious and potentially life-threatening conditions such as cancer, stroke and heart disease. There is a real need to find new medicines so we can 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."
The work, published in Diabetes Care and presented at the American Diabetes Association 79th Scientific Sessions meeting at San Francisco, took place at Imperial College London in collaboration with University of Copenhagen and University College Dublin. The treatment was trialled on patients at the National Institute for Health Research Imperial Clinical Research Facility at Hammersmith Hospital, part of Imperial College Healthcare NHS Trust.
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 from July 2016 to October 2018. Fifteen patients were randomly selected to receive the hormone treatment and 11 patients were given a saline (salt water) 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.
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 bariatric patient and 8.3kg for patients who followed a very low calorie diet.
Professor Tan commented: "Although the weight loss was smaller, using the GOP infusion would be preferable as it has fewer side effects than bariatric surgery. 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."
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 research was funded by the UK Medical Research Council (MRC) and the NIHR Imperial Biomedical Research Centre.
This research is an example of the work carried out by Imperial College Academic Health Science Centre, a joint initiative between Imperial College London and three NHS hospital trusts. It aims to transform healthcare by turning scientific discoveries into medical advances to benefit local, national and global populations in as fast a timeframe as possible.
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Notes to Editors
1. About Imperial College Academic Health Science Centre (AHSC)
The AHSC is a partnership between Imperial College London, Imperial College Healthcare NHS Trust, Royal Brompton & Harefield NHS Foundation Trust and the Royal Marsden NHS Foundation Trust, based in West London.
Established in 2007, it was the first AHSC to be created in the UK and was formally designated by the Department of Health in 2009.
The partnership brings together multi-disciplinary research and education from across all faculties at the College with the resources and critical mass of the three Trusts to advance discovery and innovation within healthcare.
The purpose of Imperial College AHSC is to utilise excellence in research and education to transform health outcomes, and support the UK's globally competitive position in healthcare related industries by increasing societal and economic gain.
The AHSC is nested within Imperial College Health Partners, the Academic Health Science Network for North West London, which will ensure that discoveries and innovations are applied on a national and global scale.
2. About Imperial College London
Imperial College London is one of the world's leading universities. The College's 16,000 students and 8,000 staff are expanding the frontiers of knowledge in science, medicine, engineering and business, and translating their discoveries into benefits for society.
Founded in 1907, Imperial builds on a distinguished past - having pioneered penicillin, holography and fibre optics - to shape the future. Imperial researchers work across disciplines to improve health and wellbeing, understand the natural world, engineer novel solutions and lead the data revolution. This blend of academic excellence and its real-world application feeds into Imperial's exceptional learning environment, where students participate in research to push the limits of their degrees.
Imperial collaborates widely to achieve greater impact. It works with the NHS to improve healthcare in west London, is a leading partner in research and education within the European Union, and is the UK's number one research collaborator with China.
Imperial has nine London campuses, including its White City Campus: a research and innovation centre that is in its initial stages of development in west London. At White City, researchers, businesses and higher education partners will co-locate to create value from ideas on a global scale.
3. About Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust is one of the largest hospital Trust's in England, providing acute and specialist healthcare for a population of nearly two million people. The Trust has five hospitals - Charing Cross, Hammersmith, Queen Charlotte's & Chelsea, St Mary's and The Western Eye - as well as community services.
4. About the National Institute for Health Research (NIHR)
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
Funds, supports and delivers high quality research that benefits the NHS, public health and social care
Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research