Microbiota and insulin sensitivity

Microbiota and insulin sensitivity

How can the gut help us to treat diabetes

Alterations in (small) intestinal microbiota are associated with aberrant insulin secretion and gut microbiota composition is ethnicity dependent (Deschaschaux/Nieuwdorp, Nat Med 2018). Moreover, we previously showed that faecal transplantation (infusing intestinal microbiota from lean donors) in insulin resistant subjects has beneficial effects on the recipients’ microbiota composition and glucose metabolism via altering faecal short-chain fatty acids (SCFA) producers levels (Vrieze, Gastroenterology 2012).
Follow-up studies suggest that this beneficial effect can be divided in responders and non-responders based on SCFA producing microbiota engraftment and beneficial metabolites (Kootte, Cell Metabolism 2017) and are donor specific (De Groot/Nieuwdorp, Gut 2020). In line, unpublished data from our group suggest that Faecal microbiota transplantation (FMT) in new onset type 1 diabetes patients also can drive beneficial effects on residual beta cell function (de Groot/Roep/Nieuwdorp, manuscript in revision). To our surprise however, oral butyrate supplementation had no beneficial effect on glucose metabolism in both type 1 and type 2 diabetes subjects (de Groot/Roep/Nieuwdorp, Diabetologia 2020; Bouter/Nieuwdorp, Clin Transl Gastro 2018) thus suggesting that replenishingspecific missing intestinal (SCFA producing) strains might be developed as therapeutics for treatment in both type 1 and type 2 diabetes. The presentation will therefore be concluded with data of our proof of concept study demonstrating how to bring these identified missing bacterial strains back to diabetic patients that lack those bacteria in their microbiome (Gilijamse/Prodan, NPJ Biofilms Microbiomes 2020).