Type 2 diabetes and the gut microbiome
The missing piece for managing type 2 diabetes? Look inside.
Did you know that more than 30 million people in the U.S. alone are now living with diabetes? That averages out to an astounding 1 in 10 Americans who are currently living with this chronic condition. While there are several different types of diabetes, type 2 diabetes (T2D) makes up the vast majority — 90 to 95 percent — of all cases.
People with T2D have trouble metabolizing sugar, which can lead to having too much sugar in their blood. Left uncontrolled, high blood sugar is a big problem. Over time, it can cause damage to the kidneys, eyes, nerves, and heart.
Blood sugar is regulated by a hormone called insulin. People with T2D either don’t make enough insulin, or they don’t respond to insulin in the way they should. To understand why that matters, it helps to know how insulin works. When blood sugar rises after a meal, insulin rushes in to usher the sugar out of the bloodstream and into cells throughout the body. If this process breaks down, as it does in people with diabetes, blood sugar levels rise.
For a long time, researchers focused on the genetic and lifestyle factors that could put people at risk for T2D. Having family members with diabetes, being overweight, and getting too little exercise are all factors. In fact, some people can avoid diabetes just by eating right and exercising more. Others might take medicines, like the commonly-prescribed metformin, to help manage blood sugar.
But recently, scientists have been exploring the ways in which T2D and the gut microbiome are connected. Briefly, the human microbiome is the collection of trillions of microbes that make their home in and on our bodies. By studying the bacteria, fungi, protozoa, and viruses that coexist in and on us, researchers are using that information to find new ways to manage T2D.
How is the gut microbiome different in people with T2D?
It’s becoming increasingly clear that the human microbiome plays many important roles in keeping us healthy. Differences in the composition of the microbiome show up in people with many chronic health problems, including T2D.
A few years ago, researchers reported some of the first evidence suggesting that T2D is linked to an imbalance in the gut microbiome. They noticed an intriguing pattern: The microbiomes of people with T2D are lacking in certain bacteria. What distinguished those bacteria was their ability to produce butyrate.
You’re probably wondering: what’s butyrate anyway? Butyrate is a short chain fatty acid that’s produced in the gut when certain species of bacteria digest complex carbohydrates, especially fibers and starches, found in foods like oats, beans, and potatoes. Without those bacteria, these carbohydrates aren’t broken down properly, and there’s limited production of butyrate.
That’s important because butyrate in the gut plays many important roles. It’s a major fuel source for cells lining the intestine, where it’s involved in immunity and inflammation. Outside the intestine, butyrate plays a role in stimulating GLP1 insulin secretion.
Early studies on the gut microbiome in patients with T2D have confirmed that the microbiomes of people with T2D are either missing or have reduced amounts of butyrate-producing microbes.
Others have tied a loss of butyrate-producing bacteria and decreased butyrate to colorectal cancer and aging. In general, the evidence suggests that butyrate-production in the gut driven by our microbial inhabitants plays an important role in our health. Butyrate appears to protect us from a variety of diseases, including T2D.
Is there a way to boost the gut microbiome (and butyrate) for T2D management?
If part of the problem with diabetes is a loss of butyrate-producing bacteria and butyrate, it stands to reason that boosting either of those might help. So, is there a way to do it?
The short answer is yes. In one study, researchers sampled the gut microbiomes of lean people and then infused their healthy microbes into people with metabolic syndrome, a condition that includes T2D. Six weeks later, they found that people who’d received an infusion of healthy gut microbes were more sensitive to insulin. As a result, they cleared blood sugar from their bloodstream more rapidly. They also had more butyrate-producing bacteria in their guts. The findings offered further evidence that treatments directed at the gut microbiome might hold promise as a new way to treat insulin resistance and diabetes.
If directly infusing a healthy, butyrate-producing gut microbiome works, how about dietary changes that help to encourage existing butyrate-producing microbes? A couple of studies show that this works too, although results vary depending upon the fiber used and the original condition of the gut microbiome.
People with a greater diversity and abundance of bacteria that produce fatty acids, including butyrate, which high-fiber diets help to encourage, showed a more marked improvement in their blood sugar levels. The findings led researchers to suggest that therapies directed at the gut microbiome through personalized nutrition offered a new way to manage T2D and other conditions.
What is Pendulum doing to help?
Such targeted treatments to help manage T2D and other conditions are exactly what Pendulum is all about. Our proprietary formula for Pendulum Glucose Control contains targeted strains of beneficial bacteria (probiotics) and a prebiotic (food to fuel those beneficial bacteria). This combination enables you to produce butyrate and better process fiber.
In fact, Pendulum Glucose Control is the first and only medical probiotic shown to effectively help manage healthy A1C levels and blood sugar spikes. In a clinical trial, Pendulum Glucose Control was shown to lower A1C levels and reduce post-meal blood sugar spikes in people with T2D. The clinical trial also showed that Pendulum Glucose Control’s efficacy was actually additive with metformin.*
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*A nutrition study demonstrated statistically and clinically significant reduction in A1C and blood sugar spikes in people with type 2 diabetes. It was randomized, double-blinded, placebo controlled, and across multiple sites in the U.S.