What happens in your gut that leads to a type 2 diabetes

There has been considerable scientific interest in recent microbiome studies related to diabetes and how it affects our disease risk. But what exactly is the microbiome and how does it relate to type 2 diabetes?

A microbiome is a population of microbes that lives in your gut, including your stomach and digestive tract. Your gut microbiome is unique to each individual and is determined by several factors including: 

• Your diet
• Your DNA
• Your activity levels
• Environmental factors (exposure to medications, toxins) 

In healthy individuals, there is a balance between the good and bad microbes in the gut and the immune system. However, many things can upset this balance and lead to disease. It has been shown there are differences in the intestinal composition in the gut microbiome of healthy people and people with diabetes. 

As microbiome studies continue to evolve, scientists are learning about the relationship between the microbiome and diabetes management. In fact, it is the bacterial changes in the gut that increase the levels of imidazole propionate, the molecule that makes the body’s cells resistant to insulin in type 2 diabetes.

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Your gut and Type 2 diabetes

In previous research led by Fredrik Bäckhed, Professor of molecular medicine at the University of Gothenburg, demonstrated that diabetes can be linked to changes in the composition of intestinal bacteria, which increases the production of molecules that may contribute to the disease.

He and his research group were able to show that altered intestinal microbiota leads to altered metabolism of the amino acid histidine. This leads to increased production of imidazole propionate, the molecule that prevents the blood sugar-lowering effects of insulin.

Now those initial findings have been confirmed in a large study of 1,990 subjects with type 2 diabetes, published in the journal Nature Communication.

“The study also shows that the levels of imidazole propionate are elevated even before the diabetes diagnosis is established, in so-called prediabetes. This may indicate that imidazole propionate may contribute to disease progression,” according to Prof. Bäckhed.

It appears that the altered gut microbiota observed in people with type 2 diabetes has fewer species than normal glucose tolerant individuals, which is also linked to other diseases.

The big question, of course, is what contributes to altering the microbiome and to this disease-causing effect?

According to Karine Clément, Professor of Nutrition at Sorbonne University, “An unhealthy diet also associates with increased imidazole propionate in individuals with type 2 diabetes.”

How to support the health of your microbiome

This isn’t the first time, and I’m sure it won’t be the last, that we learn that dietary improvements can keep type 2 diabetes at bay.

But in addition to avoiding foods that raise blood sugar, prebiotics and probiotics have been scientifically shown to support the gut microbiome in ways beneficial for diabetics. Probiotics reduce the inflammatory response and oxidative stress and increase the expression of adhesion proteins within the intestinal epithelium that reduce intestinal permeability and lead to leaky gut. All of this can improve insulin sensitivity.

Here are other diet and lifestyle tips to help:

• Add more fiber to your diet
• Avoid taking antibiotics when not medically necessary since this can damage the existing flora or gut bacteria
• Eat plenty of low glycemic fruit and vegetables
• Reduce the number of sugars and artificial sweeteners
• Reduce stress
• Regular exercise
• Good quality sleep
• Not smoking

Sources:

The gut microbiota forms a molecule that can contribute to diabetes progression — EurekAlert

What is the Gut Microbiome and How does it relate to diabetes? — DiaTribeLearn.org