Nav: Home

Diabetes drug impacts gut microbiome

February 06, 2019

Washington, DC - February 6, 2019 - Acarbose, a drug commonly used to treat type II diabetes, can change the gut microbiome in a reversible and diet-dependent manner, according to new research published in the journal mSphere. The findings highlight the importance of the gut microbiome in health and show that more attention should be paid to how the gut microbiome responds to medications.

"Acarbose has the potential to change the gut microbiome, but it is a very diet- dependent change," said study principal investigator Nicole Koropatkin, PhD, Assistant Professor of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan. "With medications, especially those that affect diabetes, we have to think about not only the impact the drug has on host enzymes or host metabolism, but how it affects gut bacterial metabolism. We know that there seem to be certain gut bacteria compositions that are more closely linked with diabetes and that might even precede the clinical onset of diabetes."

In recent years, researchers have learned that the gut microbiome of people with diabetes and otherwise healthy individuals differ. Scientists have also learned that the popular diabetes medication metformin exerts its medicinal effect, in part, by changing the gut microbiota in a manner that improves glucose tolerance. This is in addition to metformin impacting host glucose metabolism.

In her work as a protein crystallographer studying starch-degrading enzymes, Dr. Koropatkin became interested in acarbose, and set out to determine whether this diabetes drug might also spark off-target effects on the microbiota that might affect the drug's therapeutic benefits. Acarbose inhibits glucoamylase enzymes in the small intestine to prevent dietary starch digestion and thus decrease postprandial blood glucose levels. This results in an increase in dietary starch to the distal intestine where it becomes food for the gut bacterial community.

To investigate, Dr. Koropatkin teamed up with Dr. Patrick Schloss, Professor of Microbiology and Immunology at the University of Michigan Medical School, who focuses on host-microbiome interactions. They examined the effect of acarbose therapy, both a low dose and a high dose, on the gut community structure in mice fed either a high starch or high fiber diet rich in plant polysaccharides. "We wanted to try as much as we could to mimic the way that acarbose is administered to humans," said Dr. Koropatkin. "When humans start taking acarbose therapy, they usually start on a low dose, and then they move to a higher therapeutic dose."

The researchers found that the fecal microbiota of animals consuming a low dose of acarbose (25 ppm) was not significantly different from control animals that did not receive acarbose. However, feeding a high dose of acarbose (400 ppm) with a high starch diet substantial changed the gut microbiota structure. Short chain fatty acids measured from stool samples increased, especially butyrate, as a result of acarbose treatment in both diets. Most notably, said the researchers, the high starch diet with a high dose of acarbose lead to an expansion of the Bacteroidaceae and Bifidobacteriaceae and a decrease in the Verruocomicorbiacea and the Bacteroidales S24-7. Once the treatment stopped, the gut composition quickly reverted to mirror the control group, suggesting that the drug does not permanently impact the gut community. The high dose of acarbose in the plant polysaccharide diet resulted in a distinct community structure with increased representation of Bifiidobacteriaceae and Lachnospiraceae.

"Our study shows that acarbose feeding changes the gut community structure in a reversible and diet-dependent manner, which may have implications for how these medications are ideally administered in humans," said Dr. Koropatkin.

At present, Dr. Koropatkin said a high fiber diet is still the best recommendation for an individual with diabetes or a healthy person. "From everything we know about the gut microbiota, the best thing to do is eat a high fiber diet," said Dr. Koropatkin. "This is your best chance for keeping and collecting a microbiome that produces a lot of short chain fatty acids that regulate immune development and energy homeostasis."

Dr. Koropatkin said the short chain fatty acid butyrate, in particular, has received a lot of attention because it has anti-inflammatory and anti-tumorogenic effects. "Any therapy that could potentially increase butyrate production is worth considering when we think about ways to curb intestinal and systemic inflammation," said Dr. Koropatkin.
-end-
The American Society for Microbiology is the largest single life science society, composed of more than 32,000 scientists and health professionals. ASM's mission is to promote and advance the microbial sciences.

ASM advances the microbial sciences through conferences, publications, certifications and educational opportunities. It enhances laboratory capacity around the globe through training and resources. It provides a network for scientists in academia, industry and clinical settings. Additionally, ASM promotes a deeper understanding of the microbial sciences to diverse audiences.

American Society for Microbiology

Related Diabetes Articles:

The role of vitamin A in diabetes
There has been no known link between diabetes and vitamin A -- until now.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
Type 2 diabetes and obesity -- what do we really know?
Social and economic factors have led to a dramatic rise in type 2 diabetes and obesity around the world.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
The Lancet Diabetes & Endocrinology: Older Americans with diabetes living longer without disability, US study shows
Older Americans with diabetes born in the 1940s are living longer and with less disability performing day to day tasks than those born 10 years earlier, according to new research published in The Lancet Diabetes & Endocrinology journal.
Reverse your diabetes -- and you can stay diabetes-free long-term
A new study from Newcastle University, UK, has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes.
New cause of diabetes
Although insulin-producing cells are found in the endocrine tissue of the pancreas, a new mouse study suggests that abnormalities in the exocrine tissue could cause cell non-autonomous effects that promotes diabetes-like symptoms.
The Lancet Diabetes & Endocrinology: Reducing sugar content in sugar-sweetened drinks by 40 percent over 5 years could prevent 1.5 million cases of overweight and obesity in the UK and 300,000 cases of diabetes
A new study published in The Lancet Diabetes & Endocrinology journal suggests that reducing sugar content in sugar sweetened drinks (including fruit juices) in the UK by 40 percent over five years, without replacing them with any artificial sweeteners, could prevent 500,000 cases of overweight and 1 million cases of obesity, in turn preventing around 300,000 cases of type 2 diabetes, over two decades.
Breastfeeding lowers risk of type 2 diabetes following gestational diabetes
Women with gestational diabetes who consistently and continuously breastfeed from the time of giving birth are half as likely to develop type 2 diabetes within two years after delivery, according to a study from Kaiser Permanente published today in Annals of Internal Medicine.

Related Diabetes Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#SB2 2019 Science Birthday Minisode: Mary Golda Ross
Our second annual Science Birthday is here, and this year we celebrate the wonderful Mary Golda Ross, born 9 August 1908. She died in 2008 at age 99, but left a lasting mark on the science of rocketry and space exploration as an early woman in engineering, and one of the first Native Americans in engineering. Join Rachelle and Bethany for this very special birthday minisode celebrating Mary and her achievements. Thanks to our Patreons who make this show possible! Read more about Mary G. Ross: Interview with Mary Ross on Lash Publications International, by Laurel Sheppard Meet Mary Golda...