Obesity and Diabetes – Is Your Gut in Control?

Aug. 21, 2015

By Medical Discovery News

Your body is like a forest, providing a home to microscopic flora and fauna. In fact, your body is home to up to 100 times more microbes than your own cells, which make up your microbiome. While we provide them residence, these microbes help us out by providing a first line of defense against disease trying to invade our bodies, even breaking down food during digestion and producing vitamins. Now, the microbes that live in the digestive tract are helping us understand diabetes better.

According to the Human Microbiome Project sponsored by the National Institutes of Health, the microbiome plays a huge role in human health. When the microbiome is altered or imbalanced, it can cause conditions like obesity, irritable bowel syndrome, skin disease, urogenital infection, allergy, and can even affect emotion and behavior.

Recently, scientists from Israel discovered another surprising effect of the microbiome while investigating the use of artificial sweeteners in relation to glucose intolerance and diabetes. Artificial sweeteners such as saccharin, sucralose, and aspartame are commonly used in weight loss strategies because they do not add calories while still satisfying sweet cravings. However, artificial sweeteners are not always effective in managing weight and glucose, and scientists at the Weizmann Institute of Science may have figured out why.

Through experimentation they observed that adding artificial sweeteners to the diets of mice caused significant metabolic changes, including increasing blood sugar levels more than mice fed regular sugar. It didn’t matter whether the mouse was obese or at a normal weight, they all reacted the same. Dietary changes can alter the populations of bacteria in our guts, so the study addressed whether those changes affected blood glucose levels as well. After being treated with saccharin for nine days, the populations of gut bacteria in the mice shifted dramatically and corresponded with an increase in their glycemic index. Specifically, the bacterial group Bacteroidetes increased while the group Clostridiales decreased. These changes in bacterial populations is associated with obesity in mice and people.

When they administered antibiotics to reverse this and return the bacterial populations to a healthy state, it also countered the effects of saccharin, returning glucose levels to normal. To take it a step further, researchers took feces from saccharin-consuming mice showing glucose intolerance and transplanted them into other mice that had never consumed saccharin. Remarkably, those mice started showing signs of glucose intolerance.

In a study of 400 people, those who consumed artificial sweeteners had a gut microbiome that was vastly different from those who did not. They had a group of people consume high levels of artificial sweeteners for seven days, and like the rats their glucose levels increased and their microbiomes changed.

Overall, these studies show that artificial sweeteners may induce glucose intolerance instead of preventing it due to the intimate connection between the bacteria that live in our digestive systems and our metabolic state. In the future, expect to see diagnostic and therapeutic procedures that utilize our microbial friends.

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Sweet Guts

Nov. 21, 2014

By Medical Discovery News

Sweet guts

Your tongue isn’t the only part your body that can taste sweetness. Three years ago, scientists discovered that our intestines and pancreas have receptors that can sense the sugars glucose and fructose. This could revolutionize treatment for diabetics, who must closely monitor their blood sugar levels. A drug called New-Met, made by Eleclyx Therapeutics in San Diego, that is now in phase II clinical trials is attempting to do just that by targeting those sugar receptors in the digestive system.

It appears these taste receptors are basically sensors for specific chemicals that can serve functions other than taste in other parts of the body, although we don’t know what all those functions are yet. We do know the function of the T1R2/T1R3 taste receptor found on some cells in the intestine. When they detect sugar molecules, these cells secrete hormones called incretins, which in turn stimulate insulin production in the pancreas.

This neatly explains a phenomenon that had mystified scientists for over 50 years: eating glucose triggers significantly more insulin than injecting it directly into the bloodstream. When intestinal cells with sweet receptors detect sugar, they trigger neighboring cells to make a glucose transporter that allows the sugar to be absorbed by the body. The faster sugar is absorbed, the more signals are sent to the pancreas, and the more insulin it releases. Signals are also sent to the brain to tell us we are satiated. Artificial sweeteners can trigger the same effect. Understanding these signals is critically important in the control of blood sugar levels.

Metformin is a drug commonly prescribed to those with type 2 diabetes. It regulates blood sugar levels by decreasing the amount of glucose produced by the liver. Metformin may also modulate multiple components of the incretin signaling system. In combination with insulin, it increases the use of glucose in peripheral tissues like muscles and the liver, especially after meals, reducing blood sugar levels even further. Metformin is usually taken orally, so that it dissolves in the stomach and travels through the bloodstream to the liver.

New-Met is a novel formulation of metformin that dissolves when exposed to the pH in the intestine rather than the stomach. There, it binds to those sweet receptors and activates the release of incretins that stimulate the release of insulin, thereby regulating blood sugar levels. This mimics the natural signaling process triggered by sugars and is fast and direct. This reduces the amount of drug required to be effective by 70 percent. Patients on New-Met had fewer gastrointestinal side effects than those taking the standard metformin, which is the primary reason diabetics choose not to take it.

The number of people with diabetes will soon climb to 592 million, so the demand for better medications to treat them will continue to climb as well.

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