Altered Gut Flora In Obese People With Diabetes
Data from animal and human models suggest that obesity and Type 2 diabetes mellitus are associated with a profound dysbiosis.10 Gut bacteria is an important determinant of susceptibility to obesity and related metabolic diseases. Gut bacteria could also affect obesity by promoting a chronic inflammatory status.11
Animal models of obesity have made connections between an altered microbiota composition and the development of obesity, insulin resistance, and diabetes in the host through several mechanisms, such as increased energy harvest from the diet, altered fatty acid metabolism and composition in adipose tissue and the liver, modulation of gut peptide YY and glucagon-like peptide 1 secretion, activation of the lipopolysaccharide toll-like receptor-4 axis, and modulation of intestinal barrier integrity by glucagon-like peptide 2.12
Directly Targeting The Gut Microbiota Through Diet: The Concept Of A Prebiotic
The concept of a âprebioticâ was first defined by Gibson and Roberfroid in 1995 as a non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon. Initially, these species were confined to Lactobacillus and/or Bifidobacterium spp but now include other taxa including Roseburia, Eubacterium or Faecalibacterium spp. The concept of the prebiotic is also evolving as the evidence base develops, with the updated consensus from 201713 as a âsubstrate that is selectively utilised by host-micro- organisms conferring a health benefitâ, an effect no longer confined to oral administration. Initially, all prebiotics were carbohydrates but other substrates such as polyphenols and polyunsaturated fatty acids may now fit into this expanded definition.
ITFs are found naturally in over 36,000 varieties of plant species however, in some plants, inulin is used as a storage carbohydrate instead of starch making these rich dietary sources of these oligosaccharides . ITFs are also extensively used as industrial food ingredients in their extracted and synthesised form, used to replace sugar, fats and flour in processed goods for energy reduction or to produce foods with a healthier profile for the consumer. However, most clinical studies in humans have been through the direct use of supplements rather than with prebiotic- rich foods.
Best Probiotic For Diabetes
Whether youâre looking for type 1 diabetes probiotic recommendations or probiotics for type 2 diabetes, thereâs a few things to always be on the lookout for. Rather than share specific brands, because there are A LOT, I want to give you specific things to look for when youâre choosing probiotics for diabetes. Choose a probiotic with the following information on the label:
- The specific strains of bacteria contained in the supplement
- At least 1 billion colony forming units
- Choose a well-established brand with known quality manufacturing processes
- Choose probiotic strains for your specific needs. This article gives a good overview of which probiotic bacteria help certain conditions.
For specific brand recommendations, I really enjoyed this breakdown on healthline.com and encourage you to give it a read if youâre looking for a specific brand of probiotics for diabetes.
Whether you choose get your probiotics from food or from a supplement, including probiotics in your daily routine is an important part of both gut health and diabetes management.
For more information on diabetes supplements, check out the full blog post I wrote on vitamins, minerals, and supplements.
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Conditions Predisposing To Altered Gut Flora
High dietary fat, obesity, and diabetes all predispose individuals to an altered microbiota. It was found that in rats given a high-fat diet, the proportions of Bacteroides, Clostridium, and Enterobacteriaceae species increased, whereas the total bacterial density was reduced.27 Gut microbial dysbiosis and an increase in opportunistic pathogens, along with a reduction of butyrate producing bacteria, were seen in patients with T2DM.16 One of the reasons for an altered gut flora associated with a high-fat diet can be an altered bacterial adhesion to the gut mucosa.28 In another discovery, the fasting and fed states in mice correlated with a reduction and an increase in metabolic endotoxaemia, respectively. Furthermore, when the mice were given a high- fat diet for 4 weeks, the levels of LPS-containing bacteria in the gut increased chronically.25
Other Metabolic Factors Reduced By Probiotics
Probiotics also affect HbA1C levels. In one study from 2015, 60 diabetic patients were given a fermented milk with Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria for two months. The probiotic groups blood sugar levels went down from 179 mg/dl to 170 mg/dl. But their HbA1C levels also significantly decreased as well, from 7.6 percent to 6.4 percent.
The result of these types of changes will be to reduce levels of oxidative radicals in the blood, and reduce inflammation within the cardiovascular system.
This was illustrated in one of the studies reviewed. This 2014 study tested 38 people with metabolic syndrome.4 Half were given 200 million CFUs of seven strains of probiotics plus fructooligosaccharides . The other half received a placebo.
After 28 weeks of treatment, the probiotic/prebiotic group had 0.80 mmol/L reduced levels of total available glucose. They also had significantly reduced insulin resistance and reduced fasting blood sugar. In addition, the probiotic group had significantly lower LDL-cholesterol levels and significantly higher HDL-cholesterol levels compared to the beginning of the trial and compared to the placebo group.
So, you see, probiotics are not only good for digestion and blood sugar. They are also good for the heart.
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Mechanisms Through Which Probiotics May Improve Glucose Homeostasis
The change in the gut microbiome and its fermentation have been associated with T2DM . It is postulated that the overgrowth of some gram-negative bacteria may influence risk of T2DM through inflammatory pathways. For example, excessive gram-negative bacterial fragment lipopolysaccharide may lead to a leakage of gut barrier and, as a result, chronic systemic inflammation . The gut microbiota may also influence glucose metabolism by modulating the glucagon-like peptide-1 , one of enteroendocrine peptides produced by L-cell in the gut. The secretion of GLP-1 is associated with a reduction in gastric emptying time and food intake, and an increase in insulin secretion .
The Effects Of Probiotics On The Inflammatory And Immune Response Pathways
Altered production or function of circulating innate immune proteins, cellular pattern-recognition receptors and inflammatory cytokines have been linked to insulin resistance and diabetes.4141. Fernández-Real JM, Pickup JC. Innate immunity, insulin resistance and type 2 diabetes. Diabetologia. 2012 55:273-8.
Lactobacillus kefiranofaciens M and lactobacillus kefiri K were reported to mitigate progression of type 1 diabetes through inhibiting pro-inflammatory and inflammatory cytokines and elevating the production of IL-10. IL-10 inhibits the levels of pro-inflammatory cytokines and Th1 cytokines and prevents cell destruction.1919. Wei S-H, Chen Y-P, Chen M-J. Selecting probiotics with the abilities of enhancing GLP-1 to mitigate the progression of type 1 diabetes in vitro and in vivo. Journal of Functional Foods. 2015 18 :473-86. Available from: http://www.sciencedirect.com/science/article/pii/S1756464615004004. Accessed in 2017 .
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What Is The Difference Between Prebiotics And Probiotics
Probiotics are bacteria that live in your digestive tract and help your body digest the food you eat. Youâll often hear these bacteria referred to as the âgood bacteriaâ in your gut. A probiotic supplement contains these same types of bacteria .
Prebiotics are different. They are not bacteria, but rather food for the probiotic bacteria. Prebiotics are found in certain types of fiber found in foods like bananas, asparagus, chicory root, onions, garlic, artichokes, beans, and more.
Ideally, the food we eat should be rich in both probiotic bacteria and prebiotic fiber.
Probiotics Vs Antibiotics: Are They Related
Antibiotics are an amazing lifesaving tool of modern day medicine. But, they do come with side effects when you have to use them. Antibiotics wipe out bad bacteria in the gut, but they also wipe out good bacteria. So, make sure to talk to your doctor and determine if an antibiotic or other medication is truly needed, and if they think you could benefit from a probiotic supplement to help replenish the good bacteria in your digestive tract after you take antibiotics.
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Local Effects Of Probiotics In The Intestine
Endotoxemia has been identified as a triggering factor for insulin resistance in mice and suppression of endotoxemia by probiotic supplementation is considered to be a protective mechanism.4040. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev. 2007 87:1409-39. In this regard, Balakumar et al.1010. Balakumar M, Prabhu D, Sathishkumar C, et al. Improvement in glucose tolerance and insulin sensitivity by probiotic strains of Indian gut origin in high-fat diet-fed C57BL/6J mice. Eur J Nutr. 2016. . stated that probiotic interventions increased the gene expression profile of the intestinal tight junction markers and gut integrity, thereby preventing translocation of bacterial lipopolysaccharides into the systemic circulation.
Furthermore, treatment with Lactobacillus paracasei subsp. paracasei NTU 101 may lessen the risk of type 2 diabetes mellitus through increased levels of Bifidobacterium spp. and improvement of the intestinal environment. This would preserve gut integrity and prevent translocation of bacterial lipopolysaccharides into the systemic circulation.1818. Stenman LK, Waget A, Garret C, et al. Probiotic B420 and prebiotic polydextrose improve efficacy of antidiabetic drugs in mice. Diabetol Metab Syndr. 2015 7:75.
Cost Could Be An Issue
Moreover, Steinle pointed out that cost might be a problem, given it is not covered by health insurance.
The product’s website lists several options: a “no commitment” one-time 30-day supply for $198 a “3-month starter package” including two free A1c tests for $180/month and a “membership” including free A1c tests every 90 days, free dietician consultations, and “additional exclusive membership benefits” for $165/month.
“There’s a very large market out there of people who don’t find traditional allopathic medicine to be where they want to go for their healthcare,” Steinle observed.
“If they have reasonable means and want to try the ‘natural’ approach, they’ll probably see results but they’ll pay a lot for it,” she said.
Overall, she pointed out that targeting the microbiome is a very active and potentially important field of medical research, and that it has received support from the US National Institutes of Health .
“I do think we’ll see more of these types of products and use of the microbiome in various forms to treat a number of conditions.”
“I think we’re in the early stages of understanding how what grows in us, and on us, impacts our health and how we may be able to use these organisms to our benefit. I would expect we’ll see more of these probiotics being marketed in various forms.”
Kolterman is an employee of Pendulum. Steinle has reported receiving funding from the NIH, and she is conducting a study funded by Kowa through the VA.
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Living With Type 2 Diabetes This Probiotic Is Linked With Healthy Blood Sugar Levels
For the more than 37 million Americans living with diabetes, diet, exercise and sometimes medication figure prominently in the management of the disease. But did you know that research now suggests probiotic supplements could be added to that list of management tools, too?
A July 2020 clinical trial in âBMJ Open Diabetes Research and Careâ showed the combination of probiotic strains found in Pendulum Glucose Control helped reduce after-meal blood sugar spikes in people with type 2 diabetes who were also on metformin.
Translation: Keeping glucose levels steady is critical for people with type 2 diabetes â which inhibits the body from effectively absorbing sugar as a result of insulin resistance â and research indicates the gut microbiome may play a role in supporting those healthy blood sugar levels.
To explore this connection, John S. Eid, PhD and his two co-founders began using new DNA sequencing technology to create metabolic maps of the microbiome. The result was Pendulum Therapeutics, Inc. and its collection of probiotics that are uniquely targeted to offer a wide range of health solutions that are accessible for all.
Melissa Joy Dobbins Ms Rdn
The utilization of probiotics is relatively new for Type 2 Diabetes management, but perhaps not surprising given that diabetes management has evolved over the past few decades.
Evidence indicates that those with Type 2 Diabetes lack the proper balance of bacteria in their gut needed to promote glucose and insulin homeostasis. Recent research shows that there is the potential to correct this by introducing specific probiotic strains that can alter the gut microbiota to facilitate butyrate production and gut barrier stability.
While the specific strains of probiotics that will help each individual struggling to better control their Type 2 Diabetes need further investigation, there is promise according to both Dr. Mueller and Dobbins with the species Akkermansia muciniphila. This bacteria is one such strain that may actually lower postprandial glucose control in subjects who took this in a specifically formulated probiotic supplement which also contained the strains Clostridium beijerinckii, Clostridium butyricum, Bifidobacterium infantis and Anaerobutyricum hallii.
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Diet Is The Primary Modifiable Risk Factor For Both Dysbiosis And A Healthy Gut Barrier
Although more fundamental factors, such as genetics, life stage, early-life nutrition and prior/current drug exposure impact on the adult gut microbiota, the adult dietary pattern is also very important . All components of the diet have an impact on the gut microbiota however, the balance of macronutrients, in addition to the influence of the individual components are likely important and may be more relevant in terms of dietary guidelines.
How Probiotics Support Healthy Blood Sugar Levels
A BioMed meta-analysis of clinical trials found that use of probiotics can help:
- Improve insulin sensitivity and fasting blood glucose
- Reduce the production of inflammation markers
- Increase good cholesterol in the blood
- Maintain normal blood pressure by reducing blood pressure spikes
- Reduce other heart-risk factors in type 2 diabetic patients
A recent double blind, randomized controlled trial breakthrough study was done with the American Diabetes Association, which showed that test subjects with type 2 diabetes who took probiotics for 12 months, vs those who took a placebo:
- Improved glucose spike levels by 2.5%, and
- Improved A1c blood sugar by 0.6%
A1C or hemoglobin A1c is a measure of the average blood glucose level over a three-month period.Overall, the effect of probiotics is highly beneficial for people with blood sugar issues.
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The Initial Causes Probiotics For Type 2 Diabetes
Type 2 diabetes is a common condition in many people. This type is caused by a lack of insulin and is a result of an unhealthy lifestyle. The bodys inability to process glucose from the blood can damage many parts of the body, including the eyes, kidneys, and nerves. Fortunately, there are some things you can do to avoid diabetes. Here are five tips to help you lower your risk: Eat more vegetables and fruits, get regular exercise, and avoid smoking.
High levels of triglycerides in the blood are another factor that can cause diabetes. These triglycerides are caused by a buildup of cholesterol in the blood. A high triglyceride level causes the body to misrepresent insulin as a molecule, which causes glucose to build up in the blood. A simple blood glucose test can confirm your diagnosis of type 2 diabetes. By following these tips, you can begin living a healthy life and avoid the complications of diabetes.
A person with type 2 diabetes must consume less sugar. Glucose causes thirst and dehydration because the body releases energy stores into the bloodstream instead of using insulin. If untreated, diabetes can lead to weight loss and diabetic ketoacidosis, a dangerous condition whereby the cells are deprived of energy. To prevent the condition, you must make sure that your diet is low in glycemic load and that you exercise regularly.
Type 2 Diabetes And Probiotics: What Does Science Say
Probiotics are the teeny tiny bacteria that control a lot more in our bodies than we ever knew! Trillions of these guys are currently living inside of your digestive tract and impact things like blood sugar, insulin, insulin resistance, cholesterol, and many other things associated with diabetes. These little bugs are even referred to as a separate organ because they influence SO MUCH in our bodies.
There is a lot that is unknown about our gut bacteria but research is beginning to show how we can improve our gut health by including more of these healthy creatures in our diet. The trick is making sure we are getting the right bacteria into our gut!
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Probiotics To Prevent Gestational Diabetes Mellitus
We analysed evidence from randomised controlled trials investigating probiotic supplements alone or in combination with drug or non-drug interventions for preventing gestational diabetes mellitus .
What is the issue?
GDM is a condition where the mother develops high blood sugar levels, usually after 13 weeks of pregnancy. GDM is different from type 2 diabetes in that blood sugar levels are normal before pregnancy, and the levels usually return to normal after pregnancy. GDM is associated with an increased risk of developing type 2 diabetes later in life. Women with GDM are at increased risk of high blood pressure with protein in the urine and instrumental delivery or caesarean section. Their infants are more likely to be born large for their gestational age. Probiotics are good bacteria that are usually taken in the form of capsules or drinks to add to the gut bacteria. We are dependent on our gut bacteria to help digest our food, produce certain vitamins, regulate our immune system and keep us healthy by protecting us against disease-causing bacteria. Probiotics could change a persons metabolism and play a role in the prevention of GDM.
Why is this important?
What evidence did we find?
What does this mean?
There are eight studies currently ongoing that may help to provide more clarity on the effects of probiotics. It is also important to explore the relationship between probiotics and pre-eclampsia further.
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