Hormonal
Acarbose treatment improves metabolic parameters (BMI, insulin resistance, lipid profile) in type 2 diabetes patients by altering gut microbiota to increase the ratio of primary to secondary bile acids, but this benefit is contingent on the patient's baseline microbiota composition.
If you are starting treatment for Type 2 Diabetes, ask your doctor about the potential role of your gut health. This research suggests that a specific type of diabetes medication (Acarbose) works better for people who have a certain gut bacteria profile (high Bacteroides). It alters bile acids to improve metabolism, not just blood sugar. This is not a general recommendation for all patients, but a stratification strategy.
Treatment outcomes of Acarbose are dependent on gut microbiota compositions prior to treatment. Compared to patients with a gut microbiota dominated by Prevotella, those with a high abundance of Bacteroides exhibit more changes in plasma BAs and greater improvement in metabolic parameters after Acarbose treatment.
Why this rating
Randomized controlled trial with stratification, but sample size is moderate (n=94 analyzed) and specific to a Chinese population.
Source
Analyses of gut microbiota and plasma bile acids enable stratification of patients for antidiabetic treatment
Yanyun Gu et al. · Nature Communications · 2017
DOI 10.1038/s41467-017-01682-2
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