Intestinal bacteria are affected by antidiabetic drugs,
shows research

bacteria change their
composition and function when diabetic patients are treated with the drug
metformin, shows new research. In the field of disease research, changes in the
composition and function of the complex intestinal bacterial communities —
so-called dysbioses — have become a focus area. It is, however, a weakness of
the studies that researchers have not taken into account the potential effects
of drugs on the patients’ intestinal bacteria, say investigators.

Intestinal bacteria change their composition and function
when diabetic patients are treated with the drug metformin.

Most of the around 100 trillion bacteria living in hiding
in our intestines — the gut microbiota — are difficult to grow using
traditional methods, because they do not tolerate atmospheric oxygen. Within
the past few years, new research based on gene technology and advanced
bioinformatics has made it possible to analyse the composition and function of
intestinal bacteria from their DNA. The bacteria produce many different types
of substances that affect our physiology and health in numerous ways.

In the field of disease research, changes in the
composition and function of the complex intestinal bacterial communities —
so-called dysbioses — have become a focus area. It is, however, a weakness of
the studies that researchers have not taken into account the potential effects
of drugs on the patients’ intestinal bacteria.

For that reason, it is not possible to determine which
dysbiosis is associated with specific diseases and which changes in intestinal
bacteria are associated with medical treatment. At the same time, conflicting
results from research in intestinal bacteria are reported for the same disease.
It might be due to the fact that the effect of drugs on the composition and
function of the gut microbiota has not been taken into account.

European and Chinese researchers in the EU-funded MetaHIT
consortium have studied the intestinal bacterial communities from Danish,
Swedish and Chinese patients with type 2 diabetes as well as from healthy
individuals; a total of 784 people were studied. The purpose of these studies
were to separate changes in gut microbiota associated with disease from changes
that may be associated with the intake of certain types of medication. The
findings have recently been published in the international journal Nature.

The study shows that the most frequently used drug for
the treatment of high blood glucose levels, metformin, causes favourable
changes in the gut microbiota in patients with type 2 diabetes. This boosts the
capability of the bacteria to produce certain types of short-chain fatty acids,
such as butyric acid and propionic acid. These fatty acids can reduce blood
glucose levels in different ways. Metformin is, however, also known for having
adverse effects on the gastrointestinal tract, for example bloating and increased
flatulence. The study has provided the researchers with a possible explanation,
since patients treated with metformin have more coliform bacteria in their
intestines, which may be one of the causes of the inconveniences.

“We weren’t able to show that other types of
antidiabetic drugs had any actual impact on the gut microbiota . When studying
type 2 diabetes patients not being treated with metformin, we did, however,
discover that they — irrespective of whether they were from Denmark, China or
Sweden — had fewer of the bacteria which produce the health-promoting
short-chain fatty acids. Whether the lack of certain combinations of fatty acid
producing intestinal bacterial species is one of the factors contributing to
type 2 diabetes is currently being investigated,” says Professor Oluf
Borbye Pedersen from the Novo Nordisk Foundation Center for Basic Metabolic
Research at the University of Copenhagen, who is the senior author on
the Nature report.

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