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.
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.
1. OMS, Diabète avril 2016. http://www.who.int/mediacentre/factsheets/fs312/fr/
2. IDF Diabetes Atlas http://www.diabetesatlas.org/
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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.