In a recent study, researchers found a clearer picture of how the classic diabetes drug metformin works.
They found the gut microbiota plays a key role in treatment with this classic drug.
The clinical effect – control of blood glucose – is achieved through modulation of the gut microbiota.
The human body contains more bacteria than human cells.
Most of these bacteria exist in the gut, which is the most densely populated ecosystem known today, where their genes (microbiome) complements our own genome with 1000-fold more genes.
Previous research has shown that the gut microbiota is altered in patients with type 2 diabetes and after bariatric surgery.
By conducting a clinical study in patients with new-onset diabetes, the group could clarify how the gut microbiome is affected by metformin.
Although metformin has been used clinically for 60 years, it is not entirely clear how metformin works until now.
In the study, the researchers sequenced the microbiome of 22 patients before and after treatment compared with a placebo-treated group of patients.
They showed that the gut microbiome was altered dramatically within two months of treatment.
Through experiments in the laboratory, the researchers demonstrated that metformin increases the growth of several bacterial species that are linked to improved metabolism.
They also found that some patients with type 2 diabetes can control their disease with metformin, while others are not helped. Perhaps this is due to their microbiome configuration.
Moreover, the most common adverse events are intestinal problems such as diarrhea and abdominal pain.
The team suggests that they can change the intestinal flora in the future so that more people respond to treatment, and that the adverse events can be reduced by changing the gut microbiota of patients who will take metformin.
The study is published in Nature Medicine.
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