A Doctor of Naturopathic Medicine Discusses the Connection Between Diabetes and the Microbiome

Ask the Expert: "What is the connection between diabetes and the microbiome?"

Pendulum CEO and Co-Founder Colleen Cutcliffe chatted with Dr. Beverly Yates, a Doctor of Naturopathic Medicine whose area of specialty is helping women manage their blood-sugar levels, reduce stress and improve sleep.

Why is diabetes something that you care about? 

Diabetes has become a worldwide crisis.

The increase in the incidence of Type 2 diabetes around the world is stunning. In my mind, it is one of the few chronic illnesses that has had a collective increase both here in the United States and in other countries around the world.

But, we can actually do something about Type 2 diabetes. We can put a stop to it, reverse it, and make it much better.

To do that we will have to address the causes—not just treat the symptoms—of diabetes. 

What are common questions you receive from patients who come asking about how to manage blood sugar? What is your general advice?

By the time people come to me, they are typically terrified and confused.

That’s never a good combination.

I always tell people, let’s find what your secret sauce is going to be and let’s plant our flag on that one thing.

I don’t want people to be even more overwhelmed. When people are overwhelmed, they don’t do anything and they just get worse.

In our initial consultation we discuss, what’s the best place to start for you. Is it nutrition? Is it sleep, which can absolutely mess up your blood sugar. Is it stress? Stress might be the place to start for some people. Stress might be the on ramp for some people with Type 2 diabetes.

We pick one based on their symptoms. For people with high blood sugar, we’re going to work on your A1C and your fasting blood sugar. 

How is diabetes linked to the microbiome?

When it comes to the microbiome and blood sugar, there’s a lot of signaling and regulation that goes back and forth.

Sometimes people make what they think are healthy changes. However if they haven’t been able to improve their gut microbiome—and make it a healthier, more metabolically active and friendly microbiome—they won’t have the success that they’re looking for.

In other words, they won't get their blood-sugar numbers to go down—especially their A1C along with their fasting blood sugar. 


What can a person with Type 2 diabetes do right now to bolster their microbiome?

The ways in which the microbiome often gets disrupted is:

  • Repeated chronic use of things like antibiotics or
  • Eating foods that aren’t very healthy, or foods that your body doesn’t perceive as healthy

You could even be eating a healthy fiber-rich food, which is great for a person with diabetes and ordinarily which helps lower blood sugar. However, some people don’t get the full benefit of a fiber-rich diet because the organisms that currently reside in their gut microbiome aren’t the kinds that can metabolize the full benefit of the fiber. They do use the fiber and it can have other benefits, but it’s not going to help their blood sugar.

They need a prevalence of certain kinds of organisms to really be effective. Chances are they had those organisms in their childhood, and now in their adult years their microbiome is not the same. 


If they want to improve their microbiome, are there probiotics that you can take as someone with diabetes?
Only recently have there been scientific studies done to show that there are indeed probiotics that have proof, actual science, and evidence showing that they improve the microbiome and help a person directly reduce their blood sugar. 


What should someone look for when they are trying to evaluate whether a probiotic will help them with their diabetes or not?

It’s helpful always to read labels.

You want to hold companies accountable to what is actually in the bottle. You’ll want to look to see if the FDA has recognized it as G-R-A-S, or, Generally Recognized as Safe.

You should look to see if the strains that are in that probiotic are strains that are associated with having lowered blood sugar and improving the gut microbiome.

You also want to see if they are the ones that will help you fully digest and benefit from fiber-rich foods


Can you talk about the role of butyrate production in immune response and diabetes?

Butyrate does a number of things.

When it comes to short-chain fatty acids and butyrate and what goes on in the gut, people need help making the gut lining much more robust and healthy.

Some of the things that butyrate is doing is helping with digestion and helping you benefit from all the fiber that you eat.

Butyrate also helps lower blood sugar because you’re helping take the energy that the extra blood sugar glucose represents from that bloodstream and make it available inside the cell, so it’s coming across the cell wall with the help of insulin.

Now the response between insulin and glucose, like a lock and key, works a lot better. You get the energy in the cell and now it’s available to serve you and chances are you might experience more energy. 


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