Microbiota - many bacteria that live in the human intestines. The vast majority of them do not pose a threat to health. It is estimated that a person has about 2,000 different types of microorganisms, of which only 100 can become pathogenic. Recently, scientists have found that intestinal bacteria alter the effectiveness of antidiabetic drugs.
Which drug lowers blood sugar in diabetes with microbiota?
Metformin is one of the most important treatments for type 2 diabetes. The drug suppresses the formation of glucose in the liver, reduces blood sugar, reduces hunger and helps to lose weight. A possible new mechanism of action for the proven drug has now been discovered: effects on the intestinal flora.
As you know, type 2 diabetes causes adverse changes in the composition of the microbiota.
Metformin is also one of the drugs that does not cause hypoglycemia and does not lead to weight gain. New studies show that metformin mediates its beneficial effects through the intestines. Researchers from China, Denmark and Sweden analyzed stool samples from 784 people.
Researchers at the European Laboratory of Molecular Biology in Heidelberg have conducted research in molecular biology. They looked for differences in the composition of intestinal bacteria between diabetics and healthy people who had not yet been treated with an antidiabetic drug.
In patients with type 2 diabetes, the concentration of bacteria that form short chain fatty acids is reduced. These chemicals are absorbed by the intestines and used by the body. They have a beneficial effect on blood sugar. The absence of these bacteria can therefore increase blood sugar intake in type 2 diabetes.
Metformin partially reverses these processes. The study shows that drug treatment contributes to the production of short chain fatty acids in the intestines. It is possible that this effect in the intestines is responsible for lowering blood sugar.
Unfortunately, metformin also promotes the proliferation of Escherichia coli, which can lead to indigestion.
Patients experience disturbances in the intestinal flora that cause bloating and other bowel problems. We need to look for ways to treat these adverse effects of metformin without attenuating the positive effect.
Can intestinal flora also affect drug efficacy?
The interaction of drugs and intestinal flora is not one-way, but a two-way movement. Dr. Renuka Nyak and Professor Peter Turnbo of the University of California found that bacteria affect the effects of drugs. According to experts, the interindividual differences in the response to treatment are insufficiently explained by differences in the genome.
The intestinal microbiota appears to play a major role in this. First, it comes into contact with substances in the intestines. It can then metabolize drugs, thereby reducing or increasing bioavailability and effectiveness.
As scientists explain, this explains why metformin does not work when given intravenously to some people.
It is already known that about 50 active substances are metabolized by microorganisms in the intestine.
The underlying mechanisms need further study. The goal of further research is to be able to better predict the response to drugs.
New methods to improve the effects of drugs
A study by American scientists showed that regulation of the intestinal microbiota alters the effectiveness of drugs. An increase in the concentration of lactic acid bacteria enhances the effect of antidiabetic drugs reducing the blood sugar.
A scientific review showed that more than 100 bacteria affect the absorption rate and function of drugs.
Differences in the microbiota of the intestine can explain individual differences in the sensitivity of patients to antidiabetic agents. In 2019, scientists plan to test 3 new drugs that can improve the effect of modern medicines.
