May 30, 2014

The gut microbiome and metformin

By Geoffrey Martello and Nancy Liu

twitter summary: A new and innovative way to address diabetes and obesity? Learning more about what’s in your gut.

short summary: A paper in Nature Medicine takes a look at the connections between the microbes in your gut, metabolism, and medication. Learning more about the gut microbiome could lead to clues about how weight loss occurs and how complicated our metabolisms can be. This growing new field of study linking the gut to type 2 diabetes and obesity is in its infancy, and many hope future therapies could be developed from this research.

A recent article in Nature Medicine titled “Microbes, metabolism, and medications” presents an exciting new tool that may soon find a place in the diabetes and obesity treatment arsenal. Even more exciting – it lives inside you and me!

The microbes that live in our gut, also called the “gut microbiome” or “intestinal flora,” are a significant contributor to human health. These organisms serve many important roles including helping with immune function and cell tissue growth. An emerging area of research concerns the role of the intestinal flora in “host metabolism” – in other words, the organisms in our gut actually influence how we digest our food. What’s more, the intestinal flora is directly shaped by our genetics, medications, our exposure to different bacteria, diet, and more. For example, some research suggests that consuming a high-fat diet can negatively impact the gut microbiome. Other studies have found that changes in the microbiome can promote obesity.

Fascinating research on mice shows that transplanting the gut microbiome of an obese mouse can actually make a thin mouse become obese, suggesting that gut microbes influence obesity. Recent animal studies have also found that metformin may actually play a role in shaping the gut microbiome. Metformin is a first-line drug for treating type 2 diabetes, but it is also sometimes prescribed for overweight and obese individuals seeking to lose weight. Although metformin has been used for decades, new research suggests it could hold the key to new treatments that target the intestinal flora. Preliminary studies reveal the positive effects of metformin – changes in the metabolic pathways of bacteria and growth of helpful bacteria, to name a few. While the exact details remain unknown, it’s fascinating to find that the medications we take can actually affect the microbes we host.

This is an area of research that we expect to hear much more about in the coming years, for both type 1 and type 2 diabetes, as well as obesity. When we realize that we have 10 trillion cells that are host to 100 trillion bacteria, it certainly puts the importance of the gut microbiome into perspective. And remember that the next time you eat, to think about your own health along with the health of your gut microbiome!

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