Tag: type 2 diabetes

The Influence of Gut Bacteria on Diabetes Drugs

Newly emerging research seeks to investigate the effect of gut microbiota on the efficacy of type 2 diabetes drugs, suggesting that the composition of gut bacteria may illuminate why certain diabetes medications work for some people—and not others.

Estimates indicate that over 415 million people across the globe have type 2 diabetes, a statistic leading some scientists to refer to the condition as a “global pandemic.” While there is no current cure for diabetes, treatments and lifestyle changes can help those living with the disease. Yet pharmaceutical drugs for diabetes have varying rates of success, contingent on the form of administration, and results often vary from person to person.

The research, led by Hariom Yadav, PhD, an assistant professor of molecular medicine at the Wake Forest Baptist Medical Center in Winston-Salem, investigates one of the possible causes behind such varying success rates: the gut bacteria. Previous studies cited in the paper published by Yadav and colleagues demonstrate that the gut bacteria can “instigate” obesity and type 2 diabetes, and that people living with diabetes have an overall imbalance in the composition of their gut bacteria.

Moreover, as Yadav explains, there are some drugs for diabetes that are only effective when given intravenously, but not when delivered orally: leading him to believe that gut bacteria are critical in regulating how a person metabolizes drugs. “For example, certain drugs work fine when given intravenously and go directly to the circulation, but when they are taken orally and pass through the gut, they don’t work. Conversely, metformin, a commonly used anti-diabetes drug, works best when given orally but does not work when given through an IV.”

Based on these observations, the researchers sought to understand whether or not the composition of gut bacteria directly influences the efficacy of certain diabetes medications. Yadav and colleagues reviewed over 100 studies of rodents and humans, and published their findings in the journal EBioMedicine.

How the microbiome can influence drugs

The research focused on the ways in which the microbiome either enhanced or reduced the drugs’ effectiveness, finding that regulating the gut microbiome with drugs could help alter, enhance, or even reverse the success of drugs for type 2 diabetes. Yadav summarized the findings by stating: “We believe that differences in an individual’s microbiome help explain why drugs will show a 90 or 50 percent optimum efficacy, but never 100 percent…our review showed that the metabolic capacity of a patient’s microbiome could influence the absorption and function of these drugs by making them pharmacologically active, inactive, or even toxic.”

Nevertheless, researchers must conduct additional studies to “continue to decipher the interactions between the gut bacteria and diabetes drugs” in clinical practice and further applications. Yadav adds, “This field is only a decade old, and the possibility of developing treatments derived from bacteria related to or involved in specific diseases is tantalizing.”

The latest report from the Centers for Disease Control and Prevention (CDC) indicates that over 100 million adults in the United States are currently living with diabetes or prediabetes.

Why Stress May Raise Type 2 Diabetes Risk in Women

Traditional risk factors like obesity, high blood pressure, and a sedentary & nonactive lifestyle may not be the sole risk factors that can predict type 2 diabetes, as newly emerging research highlights the critical role that stress may play in the development of the condition: specifically in women.

The study, which will be presented on November 10th at the American Heart Association’s Scientific Sessions conference in Chicago, found that increasing stress stemming from traumatic events—in addition to long-term situations at home or work—was associated with ‘an almost two-fold higher risk of new type 2 diabetes cases among older women.’

Jonathan Butler, the study’s lead researcher and a postdoctoral scholar at the University of California, San Francisco’s Center for the Study of Adversity and Cardiovascular Disease, stressed the importance of taking psychosocial stressors as risk factors for diabetes “as seriously as other embraced diabetes risk factors.” Given the fact that diabetes has rapidly become one of the most serious public health issues, impacting approximately 30.3 million Americans according to data from the Centers for Disease Control and Prevention, it becomes even more imperative to “better understand risk factors for diabetes in this group,” said Butler: particularly given the fact that a majority of these people are older women.

Dr. Sherita Hill Golden, professor of medicine at the Johns Hopkins University School of Medicine in Baltimore, echoed Butler’s sentiments regarding looking beyond traditional physiological risk factors. “We’ve been trying to understand the relationship between stress, mental health and diabetes risk for a while,” as additional evidence suggests that psychosocial stress, and the ways in which people cope with stressors, may impact overall cardiometabolic health.

While previous studies focused on the relationship and correlation between stress and diabetes have focused on individual stressors, i.e. work, or symptoms of depression or anxiety, Butler and his colleagues designed a study that investigated “the joint relationship of multiple stressors with diabetes risk among women over time.”

The data included 22,706 female health professionals, all of whom who did not have cardiovascular disease; the average age of the participant was 72. Researchers collected information regarding “acute and chronic stressors and then followed the women for an average of three years.” The definitions of acute stress included both negative and traumatic life events, while chronic stress was generally related to family, work, finances, relationship, discrimination, etc. The women that had the highest levels of both acute and chronic stress presented with nearly double the risk for diabetes.

Dr. Michelle A. Albert, the study’s senior author and a professor of medicine at the University of California, San Francisco, states that the next steps will be to not only confirm the findings, but also to determine specific techniques & strategies “targeted at psychosocial stressors” that could potentially lessen, or decrease, diabetes risk in older women. She additionally communicated the importance of health care providers and clinicians inquiring about psychosocial stressors, as part of their assessment of diabetes risk, from a public health perspective.

Golden additionally stated that the new findings highlight the importance of considering the role of non-traditional risk factors, such as stress, in the development of diabetes. “We know that lifestyle intervention works for diabetes prevention, but that can be challenging if people experience cumulative stressors, like losing a job or caring for a family member, that hinder them from engaging in healthy behaviors like exercising, eating right or smoking cessation,” she said. “It’s important to assess and understand a patient’s social history. They may need a referral to a counselor or social worker.”