If you have been diagnosed with prediabetes or type 2 diabetes, your physician has hopefully told you to concentrate on healthy eating practices and exercise to help prevent the development, or progression, of the disease.
Odds are you have also heard that considering your the health of your gut bacteria or microbiota may help decrease the risk of contracting or the progression type 2 diabetes.
Maybe you also have learned that it could even reverse the condition as well.
So, what’s the truth?
Your gut microbiota is the collection of bacteria in your gastrointestinal (GI) tract that plays a role in your immunity, your ability to obtain energy from food, and more.
Your microbiota plays an important role in your health and diabetes.
“If you look at diabetes and obesity, over 600 million people in the world are obese, and over 400 million have diabetes. There are multiple factors implicated in both diseases, including genetics, culture, environment, and lifestyle,” says Ruchi Mathur, MD.
“Gut microbes may play one piece of a very large and complicated puzzle, but they’re not the be-all and end-all,” she says.
What Do We Know About The Gut microbiota?
“We know disturbances in the gut microbiota affect almost all conditions we observe in medicine. We know people living with diabetes may have a different gut microbiota than others,” says Eugene Yen, MD.
“However, we don’t yet know if you can manipulate or fix your microbiota to alter or reverse the development of the disease,” he adds.
However, there is some early evidence that altering the microbiota may help diabetes.
In a study published in October 2012 in the journal Gastroenterology, people who were obese or had metabolic syndrome and received faecal microbiota transplants from lean and skinny subjects saw their insulin resistance improve.
A faecal microbiota transplant (FMT) is a treatment that transfers stool from one person into the GI tract of another.
Medical trials using FMT are ongoing, and they may pave the way for future diabetes treatments.
However, for now, FMT’s for metabolic disease or diabetes are not standard medical practice.
“We don’t know what we need to change in someone to help improve their diabetes,” says Yen.
What Do We Understand and Don’t Understand?
“The ideal gut environment is one that’s packed with diverse and redundant microbes”, says Dr. Mathur.
“Redundancy” is the capacity for different species of bacteria to take on the same functions. Thus if one gets eradicated, the other species can then take over.
“Diabetes is associated with less diversity and less redundancy in the gut microbiota,” says Mathur, who co-authored a review published in October 2015 in the journal Nutrition in Clinical Practice that looked at the role gut bacteria play in weight gain and insulin resistance.
“We also do not clearly understand the relationship between diabetes and gut microbiota. It could be that a disrupted gut microbiota causes diseases to develop, or that diabetes alters the microbiome, or they may share a different common factor”, says Jill Weisenberger, RDN, CDE.
“This is too new to have definitive answers. As a practitioner, I say that gut bacteria might influence insulin resistance. It may also impact obesity, which influences insulin resistance, which can lead to type 2 diabetes,” she adds.
Understanding that they are connected, but not how to fix it, is frustrating, to say the least.
But it does not leave you powerless.
What Can You Do To Help Type 2 Diabetes?
“Oral probiotic supplements haven’t turned out to be the sure-fire cure yet, but research is underway to see which strains might be beneficial in certain disease states”, says Mathur.
“There is not a single probiotic out there that has been shown to change the microbiota durably,” adds Yen.
Likewise, with food sources of probiotics, there is not sufficient proof to suggest which bacterial strains and in what amount may help improve any particular disease.
However, despite this lack of evidence, including these foods regularly in your diet may lead to better health.
Not sure which foods contain probiotics to choose? Yoghurt, kefir, kombucha, raw sauerkraut and kimchi are all excellent sources of probiotics.
“Something that also may make a difference is avoiding taking unnecessary courses of antibiotics, which alter the bacterial balance in your gut”, says Mathur.
Adopting a plant-based diet may also improve the health of your gut bacteria. This diet does not mean you give up animal protein but think about eating a diverse number of plants in a wide range of colours as possible.
“Though we can’t say definitively that the gut microbiota influences diabetes management, we can say that plant-rich diets appear to provide a healthier diversity of bacteria,” says Weisenberger.
Because gut bacteria obtain their nutrients from carbohydrates, it is essential to fill your diet with veggies, whole grains, and legumes that “feed” these bacteria.
These foods have also been called prebiotics.
Onions, garlic, dandelion greens, leeks, asparagus, raw apple cider vinegar, and jicama are especially rich sources of prebiotics.
This article is not intended to provide medical advice, diagnosis or treatment.
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