The Truth About Diabetes: The Relationship Between Gut Health And Disease
Over the past several years, research into diabetes has found a link between diabetes, intestinal permeability, and gut bacteria. (1) It turns out that the microflora in your digestive tract may play a role in the development of diabetes. Healthy gut bacteria can nurture the lining of your digestive tract, while harmful bacteria can cause inflammation to spread throughout your whole body - leaving you at risk for serious conditions like diabetes. In a 2012 study, a team of researchers induced poor gut function in mice by giving them a drug we use in Western medicine called Tamoxifen. The Tamoxifen was able to completely disrupt the inner ecology of the mice. (2) Scientists discovered a strong similarity between the intestinal linings of the mice fed Tamoxifen and those with diabetes. Both groups showed improvement when given insulin. According to the group of scientists, this means that there is a noteworthy relationship between gut bacteria, gut mucosa, and diabetes. Other previous studies have found that certain external stressors have a similar effect. (3)(4) External stressors that influence microbial residents and have been linked to diabetes are things like: Antibiotic use Environmental toxins Common prescription medications While scientists are still piecing together the puzzle, so far what they do know is that external stressors can do enough damage to the lining of the gut to change its microbial residents. These changes not only effect digestion, but they can also have a systemic, or whole-body, effect. Our Inner Ecology: Just How Important Is It? Interest in the bacteria that we harbor in and on our bodies has been growing, especially since 2008 when the Human Microbiome Project (HMP) was launched. This initiative supports a full-scale investigation into cate Continue reading >>
Metformin Alters The Gut Microbiome Of Individuals With Treatment-naive Type 2 Diabetes, Contributing To The Therapeutic Effects Of The Drug
Metformin is widely used in the treatment of type 2 diabetes (T2D), but its mechanism of action is poorly defined. Recent evidence implicates the gut microbiota as a site of metformin action. In a double-blind study, we randomized individuals with treatment-naive T2D to placebo or metformin for 4 months and showed that metformin had strong effects on the gut microbiome. These results were verified in a subset of the placebo group that switched to metformin 6 months after the start of the trial. Transfer of fecal samples (obtained before and 4 months after treatment) from metformin-treated donors to germ-free mice showed that glucose tolerance was improved in mice that received metformin-altered microbiota. By directly investigating metformin–microbiota interactions in a gut simulator, we showed that metformin affected pathways with common biological functions in species from two different phyla, and many of the metformin-regulated genes in these species encoded metalloproteins or metal transporters. Our findings provide support for the notion that altered gut microbiota mediates some of metformin's antidiabetic effects. Nathan, D.M. et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 32, 193–203 (2009). Collado, M.C., Derrien, M., Isolauri, E., de Vos, W.M. & Salminen, S. Intestinal integrity and Akkermansia muciniphila, a mucin-degrading member of the intestinal microbiota present in infants, adults, and the elderly. Appl. Environ. Microbiol. 73, 7767–7770 (2007). We thank C. Arvidsson, S. Nordin-Larsson, C. Wennberg, and U. Enqvist for superb mouse husbandry Continue reading >>
Can Gut Microbiota Changes Lead To Type 2 Diabetes?
Can Gut Microbiota Changes Lead to Type 2 Diabetes? Research corroborating an association between gut microbiota alterations and type 2 diabetes has become increasingly available, although studies in humans to date havent been able to clarify whether these disturbances are a cause or an effect of type 2 diabetes. Reviewed by Clifton Jackness, MD, Assistant Professor, Hofstra Northwell School of Medicine, New York, NY There has been an explosion of interest in the human microbiome, says Vallabh (Raj) Shah, PhD, a professor of internal medicine at the University of New Mexico Health Sciences Center, in Albuquerque. The presence of dysbiosis has been established in patients with both local and systemic disease processes, he adds. In particular, an important connection between metabolic disorders and an altered microbial community in the gut has become increasingly apparent, as recent evidence in both humans and animals suggests.1,2 This link has initiated interest in the possible pathogenic relationship between gut microbiota disturbances and type 2 diabetes.3 Researchers speculate that an imbalanced gut microbiota may impair the immune system, alter signaling pathways that regulate lipid and glucose metabolism, and create low-grade inflammation, perhaps resulting in insulin resistance and eventually type 2 diabetes.4 Research in both humans and animals supports the relationship between gut dysbiosis and metabolic disorders, including type 2 diabetes, although causal inferences in humans cant be made yet. Available research supports the hypothesis that gut microbiota may indeed modulate the influence of various environmental factorsa chronically unhealthy diet, sedentary lifestyle, and repeated infectionsthat can elicit type 2 diabetes. Methodological issues in gut microb Continue reading >>
Diagnosis
Print Doctors use several tests to help diagnose gastroparesis and rule out conditions that may cause similar symptoms. Tests may include: Gastric emptying study. This is the most important test used in making a diagnosis of gastroparesis. It involves eating a light meal, such as eggs and toast, that contains a small amount of radioactive material. A scanner that detects the movement of the radioactive material is placed over your abdomen to monitor the rate at which food leaves your stomach. You'll need to stop taking any medications that could slow gastric emptying. Ask your doctor if any of your medications might slow your digestion. Upper gastrointestinal (GI) endoscopy. This procedure is used to visually examine your upper digestive system — your esophagus, stomach and beginning of the small intestine (duodenum) — with a tiny camera on the end of a long, flexible tube.This test can also diagnose other conditions, such as peptic ulcer disease or pyloric stenosis, which can have symptoms similar to those of gastroparesis. Ultrasound. This test uses high-frequency sound waves to produce images of structures within your body. Ultrasound can help diagnose whether problems with your gallbladder or your kidneys could be causing your symptoms. Upper gastrointestinal series. This is a series of X-rays in which you drink a white, chalky liquid (barium) that coats the digestive system to help abnormalities show up. Treatment Treating gastroparesis begins with identifying and treating the underlying condition. If diabetes is causing your gastroparesis, your doctor can work with you to help you control it. Changes to your diet Maintaining adequate nutrition is the most important goal in the treatment of gastroparesis. Many people can manage gastroparesis with diet changes a Continue reading >>
Diabetes Symptoms You Can’t Afford To Ignore & What You Can Do About Them
In the U.S., diabetes — or diabetes mellitus (DM) — is full-blown epidemic, and that’s not hyperbole. An estimated 29 million Americans have some form of diabetes, nearly 10 percent of the population, and even more alarming, the average American has a one in three chance of developing diabetes symptoms at some point in his or her lifetime. (1) The statistics are alarming, and they get even worse. Another 86 million people have prediabetes, with up to 30 percent of them developing type 2 diabetes within five years. And perhaps the most concerning, about a third of people who have diabetes — approximately 8 million adults — are believed to be undiagnosed and unaware. That’s why it’s so vital to understand and recognize diabetes symptoms. And there’s actually good news. While there’s technically no known “cure” for diabetes — whether it’s type 1, type 2 or gestational diabetes — there’s plenty that can be done to help reverse diabetes naturally, control diabetes symptoms and prevent diabetes complications. The Most Common Diabetes Symptoms Diabetes mellitus is a metabolic disorder that results from problems controlling the hormone insulin. Diabetes symptoms are a result of higher-than-normal levels of glucose (sugar) in your blood. With type 1 diabetes, symptoms usually develop sooner and at a younger age than with type 2 diabetes. Type 1 diabetes also normally causes more severe symptoms. In fact, because type 2 diabetes signs and symptoms can be minimal in some cases, it sometimes can go diagnosed for a long period of time, causing the problem to worsen and long-term damage to develop. While it’s still not entirely known how this happens, prolonged exposure to high blood sugar can damage nerve fibers that affect the blood vessels, heart, e Continue reading >>
Dumping Syndrome
What is dumping syndrome? Dumping syndrome occurs when food, especially sugar, moves too fast from the stomach to the duodenum—the first part of the small intestine—in the upper gastrointestinal (GI) tract. This condition is also called rapid gastric emptying. Dumping syndrome has two forms, based on when symptoms occur: early dumping syndrome—occurs 10 to 30 minutes after a meal late dumping syndrome—occurs 2 to 3 hours after a meal What is the GI tract? The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus—the opening where stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. The upper GI tract includes the mouth, esophagus, stomach, duodenum, and small intestine. The esophagus carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids into the intestine, which then absorbs needed nutrients. Two digestive organs, the liver and the pancreas, produce digestive juices that reach the small intestine through small tubes called ducts. The last part of the GI tract—called the lower GI tract—consists of the large intestine and anus. The large intestine is about 5 feet long in adults and absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is located between the last part of the colon—called the sigmoid colon—and the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum to the anus. What causes dumping syndrome? Dumping syndrome is caused by prob Continue reading >>
- Type 2 diabetes? It's 'walking deficiency syndrome' and not a real illness, says top doctor
- Diabetes Insipidus (DI) vs SIADH Syndrome of Inappropriate Antidiuretic Hormone NCLEX Review
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
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The incidence of type 2 diabetes has more than doubled since 1980, with over 382 million affected individuals worldwide, in conjunction with an increase in obesity rates and the spread of a western lifestyle ( Scully 2012 ). Given that type 2 diabetes has many comorbidities, such as hypertension, dyslipidaemia and cardiovascular disease, which contribute to the ever-rising economic burden, it is of utmost importance to develop successful therapeutic options. Chronic hyperglycaemia is a hallmark characteristic of type 2 diabetes and is, therefore, a main target for diabetes treatment. As such, metformin remains the most prescribed drug for type 2 diabetes due to its potent antihyperglycaemic effect, largely from a reduction in hepatic glucose production ( Rojas & Gomes 2013 ). Although its mechanism of action still remains largely debated, recent evidence suggests a major role of the gastrointestinal tract in mediating metformins glucose-lowering effect ( Duca et al. 2015 , Buse et al. 2016 ). Interestingly, this is not the only evidence for a therapeutic role of the gut in diabetes treatment. Over the past decade, incretin-based therapies including glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-IV (DPP-IV) inhibitors have demonstrated powerful glucose-lowering efficacy, and are now commonly prescribed, usually in conjunction with metformin ( Deacon & Lebovitz 2016 , Madsbad 2016 ). Furthermore, despite being prescribed for the treatment of morbid obesity, metabolic/bariatric surgery results in rapid and sustained remission of diabetes, and is potentially more effective than conventional therapy ( Mingrone et al. 2012 , Mingrone et al. 2015 ). The success of these treatments has expanded the classical view of the gastrointestinal (GI) tract f Continue reading >>
Why People With Type 1 Have Digestive Problems
Researchers discover a possible root cause of multiple digestive issues in people with diabetes. The longer a person lives with diabetes, the higher their risk of digestive issues. For a long time, it was unclear why, but an international study has found a possible culprit. Study researchers believe they have found that the liver of a person with Type 1 may produce an excessive amount of a protein that can hamper digestion, according to a Science Daily report. By comparing the intestinal tissue of people with and without diabetes, researchers realized that the cells lining the intestinal tract of people with diabetes were damaged by a substance called insulin-like growth factor binding protein 3 (IGFBP3). Excess IGFBP3 can cause gastrointestinal issues like irritable bowel syndrome, delayed bowel movements, bloating, and lack of bowel control; collectively, these problems are known as diabetic enteropathy. IGFBP3 cells attach themselves to colonic stem cells, which are coincidentally responsible for repairing wounds in the intestinal lining. As these stem cells are damaged, they lose the ability to make necessary repairs, thus creating a deteriorating digestive tract over time. Once researchers understood the cause of diabetic enteropathy, they were able to reverse colon damage in mice with diabetes by using a drug to block the circulation of IGFBP3 cells. The researchers, who didn’t name the drug used to reverse the colon damage, believe this treatment could be cultivated to treat previously untreatable digestive problems in humans. Of course, as people with diabetes well know, a mouse “cure” doesn’t always translate into a new treatment for humans. Still, a better understanding of the culprit behind intestinal problems in people with diabetes will likely impro Continue reading >>
Irritable Bowel Syndrome
Tweet Irritable bowel syndrome, commonly abbreviated to IBS, is a common condition and so having both diabetes and IBS is also relatively common. Both IBS and diabetes can be managed through diet and medication. Irritable bowel syndrome, commonly abbreviated to IBS, can cause uncomfortable and unpleasant symptoms. The good news is that the symptoms are not a result of damage to the gut but it is a condition that needs managing either through dietary choices, medication or other therapies. People following more restrictive diets for their diabetes may need to make some compromises between choosing a diet suitable for their IBS and one that’s appropriate for their diabetes. Symptoms Symptoms of irritable bowel syndrome include: Stomach pain or cramps, which tend to subside after passing stools or wind Bloating Flatulence Diarrhoea Constipation An urgent need to visit the toilet to open your bowels Feeling your bowels have not been fully emptied after having visited the toilet Mucus in your stools Passing blood or experiencing unexplained weight loss or anaemia are not associated with IBS. Tell your doctor if you notice any of these symptoms. Causes People with IBS tend to find that particular foods will trigger their symptoms. These food triggers typically vary from person to person but the following list are more common food triggers. Greasy foods such as chips Snacks such as biscuits and crisps Carbonated drinks such as cola and lemonade Foods containing the sweetener sorbitol Whole grain foods Dairy foods Certain raw fruits and vegetables Drinks with caffeine including tea, coffee and caffeinated cola IBS has been linked with stress, with patients reporting worse symptoms during periods of stress. Usage of antibiotics may also lead to a worsening of symptoms as the a Continue reading >>
- Type 2 diabetes? It's 'walking deficiency syndrome' and not a real illness, says top doctor
- Diabetes Insipidus (DI) vs SIADH Syndrome of Inappropriate Antidiuretic Hormone NCLEX Review
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
Diabetes And Ibs
Many people who are diabetic also experience gastrointestinal symptoms similar to IBS, so it’s not surprising that they are connected! I’m so happy to have today’s guest dietitian write about a topic that I know some of you may be struggling with – managing co-existing conditions on top of your IBS. Today we are lucky to have April Saunders, RD share her expertise on managing diabetes alongside your IBS. Take it away, April! If you have “gut issues”, meaning diarrhea, constipation, cramping, abdominal pain or nausea, and you have diabetes, you are not alone. In fact, this relationship is more common than you – or your doctor – may realize. Incredibly, 10-20% of adults worldwide suffer from functional gastrointestinal (GI) problems. For people with diabetes, this problem is even more common, and a large proportion of people with diabetes (type 1 or 2) suffer from a poorly functioning gut. Up to 75% of people with diabetes have at least one gastrointestinal symptom. A connection between people with IBS and higher rates of prediabetes has been found too, suggesting that this relationship starts early on in the pathway to type 2 diabetes. IBS and Glycemic Control IBS and other gut disorders are closely linked to diabetes. In fact, even the severity of symptoms is closely linked to the glycemic control of the individual, meaning the worse the glycemic control, the worse the GI symptoms. These GI problems can include diarrhea, constipation, abdominal pain, and vomiting. The most common GI problem that can be responsible for causing diarrhea is Irritable Bowel Syndrome (IBS), and many complex links have been identified between gut problems and blood sugars. Why do diabetes and IBS often co-exist? High blood sugars make it hard for the stomach and small intestin Continue reading >>
Role Of The Gastrointestinal Tract Microbiome In The Pathophysiology Of Diabetes Mellitus
Copyright © 2017 Muhammad U. Sohail et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The incidence of diabetes mellitus is rapidly increasing throughout the world. Although the exact cause of the disease is not fully clear, perhaps, genetics, ethnic origin, obesity, age, and lifestyle are considered as few of many contributory factors for the disease pathogenesis. In recent years, the disease progression is particularly linked with functional and taxonomic alterations in the gastrointestinal tract microbiome. A change in microbial diversity, referred as microbial dysbiosis, alters the gut fermentation profile and intestinal wall integrity and causes metabolic endotoxemia, low-grade inflammation, autoimmunity, and other affiliated metabolic disorders. This article aims to summarize the role of the gut microbiome in the pathogenesis of diabetes. Additionally, we summarize gut microbial dysbiosis in preclinical and clinical diabetes cases reported in literature in the recent years. 1. Introduction The gastrointestinal tract (GIT) harbors a dense and diverse microbial community, which includes archaea, bacteria, protozoans, and viruses, and is commonly referred to as microbiome. There are approximately 100 trillion bacteria that occupy the GIT mucosal surface, constantly interacting with metabolically and immunologically active cells. These microbes not only act as the first line of defense against foreign particles but also initiate a vast array of immunological activities that augment mucosal and systemic immunity [1]. The GIT microbiome displays very diverse physiological features: digestion Continue reading >>
The Gut: A Key To The Pathogenesis Of Type 2 Diabetes?
The Gut: A Key to the Pathogenesis of Type 2 Diabetes? In this communication we discuss the role of the gut for the development of type 2 diabetes mellitus (T2DM). Gastric emptying rates importantly determine postprandial glucose excursions and regulate postprandial secretion of the incretin hormones, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide-1 (GLP-1). It thereby also determines their powerful, amplifying effect on glucose-induced insulin secretion and thus the ability of the body to regulate glucose disposal. Although disturbances in gastric emptying are not consistent findings in type 2 diabetes, the incretin system is seriously impaired, probably associated with insulin resistance and obesity. Both of the incretin hormones lose (part of) their insulinotropic activity resulting, together with (genetically) defective beta cell function, in the impaired postprandial insulin secretion of T2DM. In addition, glucagon responses are inappropriately increased and importantly contribute to both fasting and postprandial hyperglycemia. This may involve stimulation by GIP, but evidence also points to a role of circulating amino acids, which are elevated due to steatosis-induced impaired glucagon-mediated hepatic clearance, in line with recent work suggesting that the alpha cells and the liver are linked in a close, amino acid-mediated feedback circuit. Thus, the gut plays an important role in the development of T2DM spurred by overeating and defective beta cells. The Regulation of Postprandial Plasma Glucose by the Gastrointestinal Tract The gastrointestinal tract plays a predominant role in the regulation of the postprandial plasma glucose levels. 1 The first regulating factor is the gastric antral motility which, by incompletely elucidated Continue reading >>
Gastroparesis
Gastroparesis (GP also called delayed gastric emptying) is a medical condition consisting of a paresis (partial paralysis) of the stomach, resulting in food remaining in the stomach for an abnormally long time. Normally, the stomach contracts to move food down into the small intestine for additional digestion. The vagus nerve controls these contractions. Gastroparesis may occur when the vagus nerve is damaged and the muscles of the stomach and intestines do not properly function. Food then moves slowly or stops moving through the digestive tract. Signs and symptoms[edit] The most common symptoms of gastroparesis are the following:[2] Chronic nausea (93%) Vomiting (especially of undigested food) (68–84%) Abdominal pain (46–90%) A feeling of fullness after eating just a few bites (60–86%) Other symptoms include the following: Abdominal bloating Body aches (myalgia) Erratic blood glucose levels Gastroesophageal reflux (GERD) Heartburn Lack of appetite Morning nausea Muscle weakness Night sweats Palpitations Spasms of the stomach wall Constipation or infrequent bowel movements Weight loss and malnutrition Morning nausea may also indicate gastroparesis. Vomiting may not occur in all cases, as sufferers may adjust their diets to include only small amounts of food.[3] Complications[edit] Primary complications of gastroparesis include: Fluctuations in blood glucose due to unpredictable digestion times (in diabetic patients)[4] General malnutrition due to the symptoms of the disease (which frequently include vomiting and reduced appetite) as well as the dietary changes necessary to manage it Severe fatigue and weight loss due to calorie deficit Intestinal obstruction due to the formation of bezoars (solid masses of undigested food)[4] Bacterial infection due to overgrowth Continue reading >>
Gastrointestinal Complications Of Diabetes
Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications. Clinical recommendation Evidence rating References Initial work-up for gastroparesis should include a complete history and physical examination, along with pertin Continue reading >>
- Role of the Gastrointestinal Tract Microbiome in the Pathophysiology of Diabetes Mellitus
- Diabetes Complications in Dogs and Cats: Diabetes Ketoacidosis (DKA)
- Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial
Autoimmune Disorders: When Your Body Turns On You
There’s been a stark rise in autoimmune disorders over the past 50 years, from type 1 diabetes and multiple sclerosis to celiac disease and asthma. The first step toward a cure is understanding and controlling the causes. Your immune system is your security detail. It is hardwired to differentiate between what belongs in your body and what doesn’t. When it spies a meddler, such as a virus, bacterium, or parasite, it shoots to kill. Unfortunately, the system is not perfect. Sometimes it targets healthy tissues, a situation that, if it persists under certain circumstances, can lead to an autoimmune disease or autoimmunity. “Auto” mean self; so, “autoimmunity” basically means your immune system takes aim at itself. More than 23 million Americans suffer from autoimmunity, which makes it the third most common category of illness in the United States after cancer and heart disease. Yet, 90 percent of Americans cannot name a single autoimmune disease, writes Donna Jackson Nakazawa in her book The Autoimmune Epidemic (Simon & Schuster, 2008). “It boggles the mind,” she says. The name deserves some of the blame. “Autoimmune disease” is an umbrella term for dozens of conditions, most of which do not actually use the word “autoimmune” in their titles. Some of the most common autoimmune diseases include rheumatoid arthritis, type 1 diabetes, lupus, Hashimoto’s thyroid disease, multiple sclerosis (MS), inflammatory bowel disease (IBD, which includes Crohn’s disease and ulcerative colitis), celiac disease, and asthma. The National Institutes of Health (NIH) currently labels more than 90 diseases as autoimmune disorders, and that number is certain to rise as scientists continue to identify and further understand the origin of other diseases. Type 1 diabetes Continue reading >>
