Diabetes

Type 2 diabetes continues to increase throughout the world and hygiene/diet prevention measures aren’t enough. Modulating the intestinal microbiota may become a diagnostic and/or therapeutic tool.

Prevalence on the rise

In 1980, diabetic patients were 4.7% of the global adult population. That figure has practically doubled since, particularly in low- or middle-income countries1,2. Ninety percent of cases are type 2 diabetes (T2D). The WHO predicts that the disease will be the seventh leading cause of death worldwide in 20301.

Microbiota involved

T2D is most often linked to overweight and sedentism that lead to metabolic disorders, associated with inflammation, and a loss of cell sensitivity to insulin1,3. Numerous studies have suggested that the disease is associated with dysbioses3-9. In animals, a specific bacterial profile in the intestinal microbiota is at the root of this metabolic disorder6. The abundance of Akkermansia muciniphila is inversely associated with body fat mass and glucose intolerance in mice10. These imbalances in the intestinal microbiota may contribute to inflammatory phenomena and play a significant role in the development of the disease and its severity4,5. Generally speaking, the intestinal microbiota in diabetic patients is less diverse than that of non-diabetic subjects11 for example11, there is a reduction in butyrate-producing bacterial species9,11,12 and an increase in Lactobacillus in some patients12-14.

Detection and treatment: the role of microbiota

First-line treatment for diabetes is hygiene and dietary measures and, if necessary, the addition of hypoglycemics or insulin. Furthermore, the discovery of a specific bacterial signature linked to metabolic anomalies may be used to identify patients at risk. At the same time, treating theses dysbioses by modulating the microbiota through the use of probiotics and prebiotics may then be a part of the therapeutic arsenal in the fight against T2D. To this end, studies were conducted in obese and diabetic patients following a low-calorie diet. The authors showed that the presence of A. muciniphila is associated with a better metabolic status and an improvement in insulin sensitivity.15.

Sources : 

1. OMS, Diabète avril 2016. http://www.who.int/mediacentre/factsheets/fs312/fr/
2. IDF Diabetes Atlas http://www.diabetesatlas.org/ 
3. Jin C, Henao-Mejia J, Flavell RA. Innate immune receptors: key regulators of metabolic disease progression. Cell Metab 2013 ; 17 : 873-82 http://www.cell.com/cell-metabolism/fulltext/S1550-4131(13)00201-5
4. Cani PD et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 2007 ; 56 : 1761-72.

5. Cani PD  et al. Selective increases of bifidobacteria in gut microflora improve high-fat-diet induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia 2007 ; 50 : 2374-83. https://link.springer.com/article/10.1007%2Fs00125-007-0791-0
6. Matteo S et al.. Metabolic adaptation to a high-fat diet is associated with a change in the gut microbiota.. Gut, BMJ Publishing Group, 2012, 61 (4), pp.543-53.
7. Backhed F  et al. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad SciUSA 2004 ; 101 : 15718-23.

8. Serino M  et al. Metabolic adaptation to a high-fat diet is associated with a change in the gut microbiota. Gut 2012 ; 61 : 543-53.
9. Turnbaugh PJ, Backhed F, Fulton L, Gordon JI. Diet- induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe 2008 ; 3 : 213-23.
10. Le Chatelier E  et al. Richness of human gut microbiome correlates with metabolic markers. Nature 2013 ; 500 : 541-6.
11. Everard A  et al. Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity. Proc Natl Acad Sci USA 2013;110:9066–71
12. Qin J  et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature 2012 ; 490 : 55-60.

13. Karlsson FH  et al. Gut metage- nome in European women with normal, impaired and diabetic glucose control. Nature 2013 ; 498 : 99-103.
14. Sato J  et al. Gut dysbiosis and detection of “live gut bacteria” in blood of Japanese patients with type 2 diabetes. Diabetes Care 2014 ; 37 : 2343-50.

15. Dao MC  et al. Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut 2016 ; 65 : 426-36.

Pathologies

  • Dyslipidemia

    Dyslipidemia is a common condition in the general population, which considerably increases cardiovascular risks. Treatin...
    Voir
  • Child malnutrition

    Child malnutrition is not only due to a deficit or excess in dietary intake. The intestinal microbiota may also be invol...
    Voir
  • Enteral nutrition

    Enteral nutrition is associated with dysbiosis in the microbiota often causing diarrhea. Probiotics have proven effectiv...
    Voir
  • Metabolic syndrome

    The presence of cardiovascular and metabolic risk factors, like elevated glycemia and cholesterol, hypertensi...

    Voir
  • Liver diseases

    Voir
Newsletter

Enter your email address to subscribe to our Newsletter.

BMI overview

The Biocodex Microbiota Institute: an international leader in microbiota

Voir

Choose the language in which you wish to receive the newsletter