Gut Bacteria May Play a Role in Diabetes: Research | Health

Early results from an ongoing prospective trial by Cedars-Sinai researchers suggest that a type of intestinal bacteria can contribute to the development of type 2 diabetes, while a different type can protect against it.

According to a study published in the peer-reviewed journal Diabetes, people with higher levels of the Coprococcus bacteria in their microbiome tended to have higher insulin sensitivity, while those with higher levels of the Flavonifractor bacteria in their microbiome tended to have lower insulin sensitivity.

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For years, investigators have sought to understand why people develop diabetes by studying the composition of the microbiome, which is a set of microorganisms including fungi, bacteria and viruses living in the digestive tract. The microbiome is thought to be affected by medications and diet. Studies have also shown that people who don’t process insulin properly have lower levels of a certain type of bacteria that produce a type of fatty acid called butyrate.

Mark Goodarzi, MD, PhD, director of Cedars-Sinai’s Endocrine Genetics Laboratory, is leading an ongoing study that follows and observes people at risk for diabetes to find out if those with lower levels of these bacteria develop the disease.

“The big question we hope to address is: Did the microbiome differences cause diabetes, or did diabetes cause the microbiome differences?” said Goodarzi, who is the study’s senior author and principal investigator of the multicenter study called the Microbiome and Insulin Longitudinal Evaluation Study (MILES).

Investigators involved in MILES have been collecting information from participating black and white non-Hispanic adults between the ages of 40 and 80 since 2018. A previous cohort study of the MILES trial found that cesarean delivery is associated with a risk higher to develop prediabetes and diabetes.

For the most recent study from this ongoing trial, investigators analyzed data from 352 people without known diabetes who were recruited by the Wake Forest Baptist Health System in Winston-Salem, North Carolina.

Study participants were asked to attend three clinic visits and to collect stool samples before the visits. The investigators analyzed the data collected during the first visit. They performed genetic sequencing on stool samples, for example, to study participants’ microbiomes and specifically look for bacteria that previous studies have found to be associated with insulin resistance. Each participant also completed a diet questionnaire and took an oral glucose tolerance test, which was used to determine the ability to process glucose.

Investigators found that 28 people had oral glucose tolerance results that met the criteria for diabetes. They also found that 135 people had prediabetes, a condition in which a person’s blood sugar is higher than normal but not high enough to meet the definition of diabetes.

The research team analyzed associations between 36 butyrate-producing bacteria found in stool samples and a person’s ability to maintain normal insulin levels. They controlled for factors that might also contribute to a person’s risk of diabetes, such as age, gender, body mass index and race. Coprococcus and related bacteria formed a network of bacteria with beneficial effects on insulin sensitivity. Although a butyrate producer, Flavonifractor was associated with insulin resistance; previous work by others found higher levels of Flavonifractor in the stools of people with diabetes.

Researchers are continuing to study samples from patients who participated in this study to learn how insulin production and microbiome composition change over time. They also plan to study how diet can affect the bacterial balance of the microbiome.

Goodarzi pointed out, however, that it’s too early to know how people can change their microbiome to reduce their risk of diabetes.

“As far as the idea of ​​taking probiotics, it would really be somewhat experimental,” said Goodarzi, who also holds the Eris M. Field Chair in Diabetes Research at Cedars-Sinai. “We need more research to identify the specific bacteria we need to modulate to prevent or treat diabetes, but it’s happening, probably within the next five to 10 years.”

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