Gut Bacteria Plays Role In The Effectiveness Of Metformin

For anyone who has wondered how the diabetes medication metformin helps control blood sugar, new research indicates the modulation of digestive tract microbes is involved.

“It is fascinating that it is not entirely clear how metformin works, although it has been used clinically for 60 years,” said lead researcher Fredrik Backhed, a professor of molecular medicine at the Sahlgrenska Academy, University of Gothenburg.

That intestinal bacterium might be involved with metformin’s performance is not altogether surprising since the human body houses more bacteria than human cells, and most of the bacteria live in our gut.

In earlier studies, Backhed and colleagues showed that the microbiome, or intestinal microbes are altered in individuals with type 2 diabetes following bariatric surgery. For the current study, the team looked at how gut bacteria were affected by metformin in those with new onset diabetes.

The investigators sequenced the microbiome of 22 subjects before and after treating them with metformin, and compared what they found with a placebo treated group. It was discovered that metformin substantially altered gut microbes by stimulating the growth of several bacteria species associated with enhanced metabolism.

“Transplantation of the gut microbiota from patients before and after treatment to bacteria-free mice showed that the metformin-modified microbiota may at least partially explain the good effects of metformin on blood glucose control,” said Backhed.

Further, the study sheds light on why metformin helps some people and not others; those helped by metformin likely have a microbiome more suited to the drug’s performance. It is also interesting, note the researchers, that common side effects with metformin are problems such as abdominal pain, and diarrhea.

“Imagine if we can change the intestinal flora in the future so that more people respond to treatment, and that adverse events can be reduced by changing the gut microbiota of patients who will take metformin,” says Backhed.

Source: University of Gothenburg
Photo credit: kuldeep singh

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