Association of Diabetes Care & Education Specialists

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The Role of Gut Bacteria in Diabetes

Sep 04, 2012

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.


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  1. Oct 05, 2012

    I am the manager of an outpatient diabetes education center connected to a hospital. We are wanting to provide long distance learning(telehealth) to rural areas around us. Needing advice on how to get get this done especially needing advice on equipment- cameras etc. Anyone doing this or is working on this?
  2. Sep 17, 2012

    Thanks-I wasn't able to attend this session at AADE-very interesting.
  3. Sep 11, 2012

    Dear Barbara; I found this AADE website today while I was searching something related to diabetes. The first article I looked into the site was yours regarding intestinal bacteria. There have been a huge change in our living environment, not in our bodies, including medication, within the last hundreds of years; i.e. exponentially increasing stress. It will be too complex to scientifically prove entire mechanism, but, in a very simplified way, stress dramatically increases stress hormone level, which causes wide range of damages to our body and mind. I was diagnosed as a border-line diabetes - heck, what's border-line? I am diabetic. Since then, I have been educating myself primarily to find the best and most efficient way to deal with my own diabetes. A friend of mine in Japan, who is a pharmacist, recommended me a herbal tea, of which the material is from India. You might have heard of "Salacia Oblonga". I can find a number of products in the market under this name, but none of them shows any testimonials. The products may not be made appropriately. Anyway, I found the tea from my friend works very well with me - it lowers blood glucose level and, more importantly, reconditions intestinal flora; it changes the condition of the body, and not simply adding good bacteria. A number of recent scientific researches prove the efficacy of Salacia Oblonga is 5 to 10 times superior than taking any probiotic in the market. It is more than clear that soil reconditioning would bring maximum harvest than adding tons of seeds into inappropriate soil. I would like to recommend this tea to everyone who is suffering from diabetes and/or intestinal problems. If you want to know more details, please send me an e-mail to me (Motto Nakajima at
  4. Sep 08, 2012

    I am a proponent of a daily probiotic suppliment for colon health and immune system strength, especially as one ages beyond 50.
  5. Sep 06, 2012

    How amazing Barbara! I have been trying to encourage the use of Traditional cooking methods for years! More reasons to slow cook and eat more " nourishing broths" (Little Women). I have been waiting for researchers to explain the why's of controlled bg after gastric bypass. So happy to hear a hypothesis! Thank you for commenting! Karmen Cunningham RN, BSN, CDE

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