Focus on the intestinal microbiota of individuals with prediabetes

Prediabetes is characterized by a higher than normal blood sugar level, which is however lower than that of diabetic patients. It is the phase which often heralds a diagnosis of type 2 diabetes, a disease recognized as being associated with an imbalanced intestinal flora. Danish researchers studied the flora of prediabetic patients to see if there are early markers of the disease.

 

The team chose to observe the intestinal microbiota of untreated prediabetic individuals, so as not to bias the results. While the intestinal microbiota can be used in diabetic patients as a diagnostic tool and to develop personalized treatments, recent data suggest that metformin (an antidiabetic drug commonly prescribed to 415 million patients worldwide) modifies the composition and function of the intestinal flora.

A microbiota that is already abnormal...

After comparing 134 people in good health with the same number of overweight, insulin resistant, prediabetic individuals, with low-grade inflammation (low-level or with no symptoms), and with high blood lipid levels, the verdict was reached: the intestinal microbiota of the prediabetic participants was already imbalanced (a condition referred to as "dysbiosis"), as indicated by the bacterial depletion observed, especially of Clostridium and Akkermansia muciniphila. Second step: fecal transplants (the transfer of microbiota from a donor to the digestive tract of a recipient) to see if the impaired flora of prediabetic patients produces an abnormal level of blood glucose. In the absence of conclusive data on this point, the role of intestinal microbiota in the emergence of type 2 diabetes deserves to be clarified at a later date.

… and correlated with a metabolic syndrome

Another result to be explored in depth: some bacteria present exclusively in affected individuals have in the past been linked to chronic diseases such as inflammatory bowel diseases, atopic dermatitis, and colorectal adenoma. In the opinion of the researchers, these facts support the existence of a microbial signature associated with low-grade inflammation. For them, these elements moreover confirm the hypothesis according to which a disrupted intestinal microbiota could cause the development of certain diseases in genetically predisposed individuals.

 

Sources:

Allin K. H., Tremaroli V., Caesar R. et al ; Aberrant intestinal microbiota individuals with pre diabetes ; Diabetologia.