Medics behind a new trial injection to tackle obesity and diabetes are working with Abu Dhabi researchers on the next stage of its development.
Imperial College London last week released results of a small scale study in which 15 overweight patients were given a daily hormone jab over four weeks.
On average, patients lost about 4.4 kilograms owing to the injections, which contained gut hormones that cause appetite changes.
"One place that has a significant problem with obesity and consequently, diabetes, is the Emirates," Professor Sir Stephen Bloom, co-author of the research, told The National.
“We get research support from Imperial College London Diabetes Centre in Abu Dhabi.
“Specialists from the centre were involved in this particular trial.”
Prof Bloom's team presented the findings at a diabetes summit in San Francisco.
Imperial College London is now working on research with its Abu Dhabi branch to recreate a weekly version of the injection, although it may take some years before the treatment is widely available.
As part of the original study, a further 43 patients who had undergone either bariatric surgery or followed a low-calorie diet were also given the hormone treatment. The patients who underwent bariatric surgery plus the injections lost an average of 10.3kg and those on diets plus the jabs lost 8.3kg in one month.
Findings from the trial also showed substantial improvements to blood glucose, with some patients reducing to near-normal levels.
About 30 per cent of the world’s population is obese or overweight, according to the World Health Organisation.
In the Middle East, the figures are alarmingly high. Thirty seven per cent of the UAE population is obese and 19 per cent have been diagnosed with type 2 diabetes.
Bariatric or gastric bypass surgery is considered an effective medical way to treat obesity, but remains invasive. Some patients are left with abdominal pain, nausea, vomiting and debilitating low blood sugar levels.
The research team wanted to look at what was effective in the surgery.
“It was the increased release of gut hormones that tell the brain to stop eating while we digest a meal," Prof Bloom said.
“It was that combination of hormones, which we trialled in this research. It was the first time they were put together in one injection."
The medical name for the hormone combination is glucagon-like peptide-1 (GLP-1), oxyntomodulin and peptide YY, but is referred to as GOP for short.
“The injection, much like bariatric surgery, reset the appetite control system in the brain.
“It worked to reduce food intake and therefore decreased calorie intake.”
Although still in its trial phase, doctors in the UAE support the idea of long-term GOP treatment for obese and diabetic patients.
“Borderline diabetic patients will benefit from it," said Dr Girish Juneja, head of the bariatric centre at Al Zahra Hospital in Dubai.
“It will be an effective option for low-grade obesity patients with a BMI starting from 27 and up.”
However, he said it would not be the best option for patients with high-grade obesity BMI of 35 or more.
“Surgery will still be the most successful procedure," he said.
At present, there is an injection available in the UAE called Saxenda, which contains GLP-1 (agonist); one of the three hormones used in this latest clinical trial.
But Prof Bloom said the GOP combination injection mimicked the results of bariatric surgery more effectively.
While the latest clinical trial showed weight loss of between 4kg to 10kg over four weeks, depending on patient profile, he said the long-term weight loss when using GOP would be much greater.
“You will lose 30-40 per cent of your body weight, mainly fat, at a steady rate," he said.
“The evidence is based on the results experienced by bariatric surgery patients.”
Although widely described as a "jab", the treatment in the trial was not a single injection and patients were connected to a pump for 12 hours a day. The next stage of research is aimed at improving that.
And for those looking for a quick fix weight loss solution, the injection is not the answer.
“Pending completion of all medical trials, this injection will need to be medically prescribed by a doctor, with patient criteria in place, for long-term use," Prof Bloom said.
“With a high rate of pre-diabetic, obese, and diabetic patients in the UAE, there is a considerable need for such a non-invasive treatment here."
Patient: 'I was desperate to change my situation'
Alan, 63, a retired civil servant, was part of the GOP injection patient trial in the UK.
Weighing 115kg, he was diagnosed with type 2 diabetes in September 2017.
He began the trial with Imperial College London in October 2017 and lost 3.7kg in four weeks.
"I agreed to do it because I was desperate to change my situation," he told The National.
“I was still in denial over my diagnosis. Before starting the trial I was already taking four tablets a day for my diabetes.
“It was a tough transition knowing I’d be on tablets long-term.”
After briefing sessions with the clinical trial team, several one-to-one discussions with a dietetic on healthy eating, and a three-day education workshop on how to self-administer the injection, Alan began his treatment phase.
“I had a small needle attached to my stomach and carried a small pump, maybe the size of a mobile, that injected the GOP hormones under my skin on a daily basis.”
The device was attached one hour before breakfast and disconnected after the last meal of the day.
“It took a few days to get the hang of attaching it myself, but after that I barely noticed it was there.
“It was non-invasive, that’s why I put myself forward for the trial.”
Following the GOP injection treatment, Alan not only lost weight, he reduced his diabetes medication intake from four tablets a day to two. And after joining a subsequent diet research programme, he has since lost 25kg.