Could Gut Microbiome be the ?Holy Grail? for Diabetes Treatment?


The opening speaker at the American Association of Clinical Endocrinologists? (AACE) 25th Annual Scientific & Clinical Congress said that although recent discoveries about human gut microbiome and its relationship to diabetes are promising, a number of hurdles must be overcome before microbiome?s potential to contribute to diabetes prevention or treatment therapy can be realized.

Addressing a full house at the event, American Diabetes Association (ADA) Chief Scientific and Medical Officer Dr. Robert E. Ratner, FACP, FACE, highlighted findings of recent microbiome studies made possible with the advent of gene sequencing methodology, which revolutionized researchers? ability to analyze with greater precision the gut microbiome?the vast ecosystem made up of trillions of bacteria, viruses, and fungi that reside within us from birth to death.

A number of the studies have produced evidence that increasingly suggests gut microbiome not only influence the development of diabetes (either positively or negatively), but may also hold potential as a diabetes prevention or treatment therapy.

?Our gut clearly plays an important role in our metabolic function since we can associate a variety of different, specific bacteria in the gastrointestinal tract to immune function in type 1 diabetes and to energy metabolism and obesity in type 2 diabetes,? Ratner said, ?but we are currently at the stage where the science is associative.?

?Keep in mind that we have 100 trillion bugs in our body, so trying to figure out which one, two, or three of them is having the effect is rather difficult,? he continued. ?We need to move to the next step, which is identifying the specific components of pathogenic or protective organisms within the microbiome that drive metabolic changes and establishing a causal relationship, but we?re not there yet.?

Part of the challenge lies in the gut microbiome?s dynamic composition, which is constantly changing in response to a person?s diet and environment (hygiene, medication use), Ratner noted. Plus, researchers have yet to determine the ?optimal? composition of gut microbiota, if there even is one. Additional challenges include the need for standardized methodologies for study design, sample collection, and data analysis; a so-called microbiome ?bio bank?; and the proper funding and infrastructure necessary for a centralized organization such as the National Institutes of Health (NIH) to oversee data collection.

?While there is so much more to be learned and to be done, the clues we are seeing right now suggest that microbiome most likely have a very important role in influencing diabetes and metabolism,? Ratner said.

About the American Association of Clinical Endocrinologists (AACE)

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