Entries in Diabetes (3)


Gut microbiome transplantation, and use of probiotics and prebiotics as new treatment for both diabetes type 1 and 2

See also: Liam Davenport, Medscape Medical News © 2015. Eur J Endocrinol. 2015. Published online March 24, 2015.  He C, Shan Y, Song W. Nutr Res. 2015 Mar 14. Targeting gut microbiota as a possible therapy for diabetes.

People who take multiple courses of antibiotics may face an increased risk of developing both type 1 or type 2 diabetes, potentially through alterations in gut microbiota, conclude US researchers.

The team, led by Ben Boursi, MD, at the University of Pennsylvania, Philadelphia, found that the risk of diabetes was increased by up to 37%, depending on the type of antibiotic and the number of courses prescribed.

"Our findings are important, not only for understanding how diabetes may develop, but as a warning to reduce unnecessary antibiotic treatments that might do more harm than good," commented Dr Boursi in a statement.

The More Courses of Antibiotics, the Greater the Risk

Dr Boursi explained that studies both in animal models and humans have shown an association between changes in gut microbiota in response to antibiotic exposure and obesity, insulin resistance, and diabetes.

Speaking to Medscape Medical News, he noted: "In mice, we know that germ-free mice are lean and, by fecal transplantation, we can transmit obesity to them. We also know that low dose of penicillin may induce obesity in mice models."

He added that there have been several studies in humans indicating that exposure to antibiotics in early childhood is associated with an increased risk of obesity in later life, while other investigations have reported differences in gut microbiota between people with and without diabetes.

To investigate further, Dr Boursi and colleagues conducted a nested case-control study using data from the Health Improvement Network (THIN), a UK population-based database, from which they identified 1,804,170 patients with acceptable medical records.

From the original cohort, they were able to select 208,002 diabetes patients and 815,576 controls matched for age, sex, general practice site, and duration of follow-up before the index date.

Conditional logistic regression analysis revealed that exposure to a single antibiotic prescription was not associated with an increased risk of diabetes, adjusted for body mass index (BMI), smoking, last blood glucose level, and the number of infections before the index date, alongside a history of coronary artery disease and hyperlipidemia.

However, treatment with two to five courses of antibiotics was linked to an increased risk of diabetes with penicillin, cephalosporins, macrolides, and quinolones, at adjusted odds ratios (ORs) ranging from 1.08 for penicillin to 1.15 for quinolones.

The highest risk for diabetes was seen among people who received more than five courses of quinolones, at an adjusted OR of 1.37. An increased risk of diabetes was also seen in patients who took more than five courses of tetracyclines, at an adjusted OR of 1.21.

Interestingly, the researchers were unable to find an association between diabetes risk and treatment with imidazole, antiviral drugs, and antifungals, regardless of the number of courses.


Next Steps

When the analysis was restricted to type 1 diabetes, the risk was increased only following exposure to more than five courses of penicillin or two to five courses of cephalosporin, at odds ratios of 1.41 and 1.63, respectively.

Commenting on the findings, study coauthor Yu-Xiao Yang, MD,  pointed out their investigation was observational in nature. "We are not able to establish cause and effect necessarily, but it is actually pretty consistent with the experimental data, which is more definitive in terms of the animal data than in humans."

Dr Yang said that the next step will be to expand the focus, as the antibiotics data "provide indirect evidence suggesting the importance of gut microbiota on metabolic outcomes, including diabetes."

Describing their findings as "important evidence," he concluded: "Based on this indirect evidence and existing data in animals, we are planning to more directly investigate the effect of altered microbe environments in humans."

Targeting gut microbiota as a possible therapy for diabetes
Accumulating evidence suggests that compositional changes in the gut microbiota in type 2 and type 1 diabetes contribute to the pathogenesis of diabetes. Several studies have demonstrated that patients with diabetes are characterized by a moderate degree of gut microbial dysbiosis. However, there are still substantial controversies regarding altered composition of the gut microbiota and the underlying mechanisms by which gut microbiota interact with the body's metabolism, inflammation, the immune system, gut permeability, insulin resistance, and the bowel function of the intestinal barrier.

We introduce gut microbiome transplantation, and use of probiotics and prebiotics as new treatment for diabetes
Future research will be focused on defining the primary species of the gut microbiota and their exact roles in diabetes, potentially increasing the possibility of gut microbiome transplants as a therapeutic strategy for diabetes.




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Type 2 diabetics can significantly lower their blood sugar

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Pablo Picasso. Baigneuses au ballon, 1928. Oil on canvas. Private Collection.
Presently on display in Zurich, Picasso - The 1932 Retrospective from the Kunsthaus Zurich, Oct. 15, 2010 until Jan. 30, 2011.


From The New York Times, November 24, 2010



Type 2 diabetics can significantly lower their blood sugar — and lose body fat in the bargain — with an exercise program that combines aerobics and weight lifting, a new study reports.

While that regimen is already recommended for Type 2 diabetes, researchers say the study, published Nov. 24 in The Journal of the American Medical Association, offers some of the best evidence to date that a combined program offers greater benefits than aerobics or weight lifting alone, even if it does not increase total exercise time.

“We can now look at individuals with diabetes right in the face and tell them, ‘This is the best exercise prescription for you,’ ” said the paper’s lead author, Dr. Timothy S. Church, director of preventive medicine research at Pennington Biomedical Research Center at Louisiana State University.

Such a program consists of “about 100 minutes of higher-intensity aerobics a week, and then give yourself one to two days of resistance training for 15 to 20 minutes a day,” he said.

The study randomly divided 262 inactive Type 2 diabetics, average age 55.8, into four groups — 73 assigned to resistance training three days a week, 72 to aerobic exercise, 76 to the combination and 41 to a non-exercise comparison group. The study was notable in that almost half the participants were not white, and 63 percent were women.

After nine months of observed exercise, participants who did the combination training lowered their blood level of the glucose marker HbA1c to 7.3 percent from 7.7 percent, on average, a drop that corresponds to a significantly reduced risk of heart disease, Dr. Church said. The improvements in the other exercise groups were not significantly different from those in the non-exercise group.

Dr. Church said he was surprised but added that the findings made sense. “Diabetes is the failure to control the amount of sugar in your blood, and the biggest user of blood sugar is skeletal muscle,” he said. “The healthier your skeletal muscle, the more blood sugar it’s chewing up and taking out of the blood.”

Janina. Untitled. 2010. 

Whole body vibration training is optimal for regaining your strength and balance.