ADA 2019—GOP combo bests gastric bypass, restricted diet for some outcomes


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • A combined infusion of glucagon-like peptide-1 (GLP-1), oxyntomodulin, and peptide YY (known as GOP) leads to improved glycemia, body weight reductions.
  • Glucose tolerance, variability outcomes best those of gastric bypass, very-low-calorie diet (VLCD).

Why this matters

  • One effect of Roux-en-Y gastric bypass (RYGB) is increased levels of GOP, and infusion of GOP reduces energy intake.

Key results

  • Weight loss was greater with GOP vs saline: mean change, −4.4 (95% CI, −5.3 to −3.5; P=.025).
  • GOP-associated weight loss (4% from baseline) was less than with RYGB (8.8%) or VLCD (7.56), however.
  • GOP bested RYGB for reducing fasting glucose but did not differ from VLCD.
  • Glucose tolerance after mixed-meal stimulus was better with GOP vs either intervention.
  • Glycemic variability was also dampened more with GOP vs RYGB or VLCD. 
  • The infusions were well-tolerated.

Study design

  • Single-blinded trail of patients with obesity and prediabetes/diabetes.
  • 15 had GOP, 11 had saline, each for 4 weeks.
  • Authors also analyzed data for 21 patients who had RYGB and 22 on VLCD.
  • Outcomes included body weight, glucose tolerance, glucose variability. 
  • Funding: UK Medical Research Council, others.

Limitations

  • Infused only 12 of 24 hours.
  • Small population, short duration.

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