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<p>The recognition that incretin secretion is impaired in type 2 diabetes stimulates consideration of a similar trial in diabetic patients.</p>

Manipulating the Microbiome to Enhance Metabolic Functions

SOURCE: Simon MC, et al. Intake of Lactobacillus reuteri improves incretin and insulin secretion in glucose-tolerant humans: A proof of concept. Diabetes Care 2015;38:1827-1834.

The content of the microbiome — that is, the diversity and relative proportion of various intestinal bacteria — has been increasingly recognized as an important component in fundamental metabolic paths. Indeed, it has been suggested that an altered microbiome may be a key factor in the development and maintenance of overweight and obesity. Animal studies have shown that altering the microbiome by means of probiotics resulted in enhanced plasma levels of glucagon-like peptide (GLP).

Simon et al performed a double-blind, randomized, prospective trial among healthy volunteers who ingested capsules of the probiotic Lactobaccilus reuteri (or placebo) twice daily for 4 weeks. The healthy volunteers were comprised of both lean and obese individuals.

The group that received the probiotics demonstrated increased insulin levels. Enhanced GLP levels were also seen in the probiotic group, albeit only in lean volunteers. Markers of insulin sensitivity were unchanged. Summarily, the data support that concept that addition of L. reuteri enhances release of incretins in healthy subjects. The recognition that incretin secretion is impaired in type 2 diabetes stimulates consideration of a similar trial in diabetic patients. Because this was a short-term trial, these data cannot speak to the issue of whether probiotic utilization might impart long-term benefits.