I could not attend this year's AADE 2012 annual meeting due to family events. But during the meeting, I bounced around the website to see if I recognized any of my friends and colleagues in the photo gallery, scanned some of the posters and briefly listened to some of the breakout sessions.
One session that caught my attention and made a note to listen to more closely was by Beverly Thomassian. Her topic was “New Frontiers in the Prevention of Type 1 and Type 2 Diabetes: Diabetes Educators Needed.” She was a very energetic and enthused speaker, which came across well on the Virtual Meeting site, so I caught back up with her this weekend.
Her main focus was discussing new research regarding the role of gut bacteria and gut hormones. Yes, you read that correctly, GUT BACTERIA. We have all been reading about gut hormones (think incretins), but there is compelling information on the role bacteria plays in diabetes.
I did not realize that bacterial cells in the body outnumber human cells 10 to 1! YUCK!
According to Beverly, normal gut bacteria are important and help us utilize energy and fight off invaders. Researchers are also looking at the role bacteria play in diabetes and even in obesity.
Weight and gut bacteria research is showing that leaner people have more bacterial diversity and more bacteroidetes. The more bacteroidetes you have, the easier it is to lose weight. On the other hand, another gut bacteria known as firmicutes are found in greater quantities in the intestine of obese people. It turns out these firmicutes are more efficient at extracting calories from food.
There is also a relationship with gastric bypass surgery. According to Beverly, in gastric bypass surgery the diversity of gut bacteria increases with more bacteroidetes and less firmicutes. I am sure you have read articles about how almost immediately post-gastric bypass glucose values are normalized often times even before the person has lost any weight. Some studies suggest that the change in glucose may be related to the change in gut bacteria.
Now the question is what role do gut hormones play in beta cell function? Interestingly, Type 1 DM has increased 23 percent from 2001 to 2009. In fact, autoimmune diseases are increasing across the board. This cannot be due to genetics since the human body has not changed in the past several hundred or even thousand years. So what could be causing this? Is it solely due to the obesity epidemic or could there be some relationship between the change in environmental exposure and gut bacteria? Is there a relationship between the use of antibacterial products and the increase in autoimmune disease? The Hygiene Hypothesis suggests that as we get "cleaner" we are depriving our gut of the bacteria it needs to fight off germs, bacteria, etc. This is certainly something to ponder and I look forward to hearing more about it in the future.