Greenway F, Wang S, Heiman M
Pennington Biomedical Research Center, Outpatient Clinic, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
Pennington Biomedical Research Center, Outpatient Clinic, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, 1000853, China PR.
Benef Microbes. 2014 Mar;5(1):29-32. doi: 10.3920/BM2012.0063.
The gut microbiome plays an important role in regulation of metabolic processes, including digestion, absorption, and synthesis of bioactive molecules that signal physiological host mechanisms. Changes in the human gut microbiome are associated with type 2 diabetes and insulin resistance. Water-soluble dietary fibres like inulin and beta-glucan are fermented in the colon, and beta-glucan increases viscosity. Blueberries improve insulin sensitivity through an antioxidant effect. A cobiotic, consisting of purified inulin, sugar-free blueberry pomace extract, and an oat preparation of purified beta-glucan was developed for twice a day (bid) consumption as a smoothie drink to repair the gastrointestinal dysbiosis in type 2 diabetes. A 30-year-old man presented with new onset type 2 diabetes and a fasting glucose (FBS) of 375 mg/dl. Metformin 500 mg bid was initiated and increased to 1 g bid after 1 week. During the first 9 days of metformin treatment, he developed diarrhoea, but his FBS only dropped to 325 mg/dl. The cobiotic bid was added on the 9th day of metformin treatment, and after 2 days, his FBS dropped to 175 mg/dl. After 8 weeks on metformin and the cobiotic, his blood sugar was 100 mg/dl and he lost 5.5 kg. His stools became soft and formed on the cobiotic, reverted to diarrhoea when off of it for 2 days, and returned to normal on resuming the cobiotic formulation. Metformin is a safe, effective and inexpensive generic medication favouring weight loss, recommended as initial treatment of type 2 diabetes by the American Diabetes Association. However, a 20% incidence of diarrhoea limits its tolerability. A safe food supplement that can increase the efficacy of metformin and its tolerability, as occurred in this case report, would have significant positive public health consequences. A controlled clinical trial of the cobiotic with metformin is planned.
肠道微生物群在调节代谢过程中发挥着重要作用，这些代谢过程包括消化、吸收以及生物活性分子的合成，而这些生物活性分子能够调节宿主的生理机制。人类肠道微生物群的变化与2型糖尿病和胰岛素抵抗有关。菊粉和β-葡聚糖等水溶性膳食纤维在结肠中发酵，β-葡聚糖会增加黏稠度。蓝莓通过抗氧化作用提高胰岛素敏感性。一种合生制剂被开发出来，它由纯化菊粉、无糖蓝莓果渣提取物和纯化β-葡聚糖的燕麦制剂组成，作为奶昔饮料，每天服用两次，用于修复2型糖尿病患者的胃肠道生态失调。一名30岁男性被诊断为新发2型糖尿病，空腹血糖（FBS）为375mg/dl。开始服用二甲双胍500mg，每日两次，1周后增至1g，每日两次。在二甲双胍治疗的前9天，他出现腹泻，但空腹血糖仅降至325mg/dl。在二甲双胍治疗的第9天加用合生制剂，每日两次，2天后，他的空腹血糖降至175mg/dl。在服用二甲双胍和合生制剂8周后，他的血糖为100mg/dl，体重减轻了5.5kg。服用合生制剂后他的大便变软且成形，停药2天后又恢复腹泻，重新服用合生制剂后恢复正常。二甲双胍是一种安全、有效且廉价的有利于减重的非专利药物，美国糖尿病协会推荐其作为2型糖尿病的初始治疗药物。然而，20%的腹泻发生率限制了其耐受性。一种能够提高二甲双胍疗效及其耐受性的安全食品补充剂，如本病例报告中所述，将对公众健康产生重大积极影响。计划对合生制剂与二甲双胍进行对照临床试验。
