World Diabetes Day

A record number of patients worldwide suffer from metabolic disorders, including obesity, nonalcoholic fatty liver disease, and cardiovascular disease. Similarly, the figures for type 2 diabetes (T2DM) patients are spiking worldwide. At the moment 463 million people have been diagnosed with diabetes, and this number is expected to rise to 700 million by 2045. Sadly, nearly a century since the discovery of insulin, many people don’t have a proper access to diabetes prevention and treatment. As poor diet, lack of exercise, and other stressors continue to afflict millions, we must look for new ways to improve metabolic health, delay disease progression, and foster a better quality of life wherever possible.

Insulin Resistance and low-grade inflammation at the core of metabolic disorders
Currently metabolic health has no strict definition; often it is described as the absence of metabolic disorders. Rising levels of blood sugar, triglycerides, low-density lipoprotein LDL cholesterol, blood pressure, and waist circumference are generally associated with metabolic disorder and increased risk of diseases ranging from mild insulin resistance to prediabetes, T2DM, and cardiovascular disease¹. Both insulin resistance and systemic low-grade inflammation appear central to such metabolic disorders^2–4.

One of the best-studied metabolic regulatory systems is glycemic control. The hormone insulin features in blood glucose homeostasis, as does insulin resistance in many of the aforementioned chronic diseases. Insulin resistance is marked by a reduction in the cells sensitivity to the action of insulin. Thus, the pancreas needs to produce more insulin to lower blood glucose levels. Over time, the pancreas may no longer be able to cope with the high demand, and prediabetes can progress to diabetes⁵.

T2DM is the prototypical disease associated with insulin resistance and low-grade inflammation^2,3. Typically, insulin resistance and low grade inflammation develop gradually in individuals genetically prone to this disease who also lead unhealthy lifestyles⁶. In diabetes, insulin production is impaired while cells are insulin resistant. Consequently, the serum levels of insulin are insufficient to maintain blood glucose, yielding high levels of blood glucose, which can have detrimental effects such as heart disease, stroke, and kidney failure.

The influence of gut microbiota in metabolic health
Recent research indicates an important role for the gut microbiota in metabolic health⁷. Disturbance of gut microbiota due to e.g. a typical western lifestyle triggers changes in the serum lipopolysaccharides (LPS), short-chain fatty acids and bile acid, resulting in systemic low-grade inflammation and insulin resistance^8–10. Numerous studies have confirmed the role of the gut microbiome in T2DM^8,9,11.

Various evidence supports the gut’s integral role in insulin resistance. For example, fecal microbiota transplantation from lean donors to human male recipients with metabolic syndrome was linked with significant improvement of insulin sensitivity and glucose metabolism¹². Furthermore, improvement in glucose metabolism was linked with significant to alteration in the gut microbiota and increased beneficial bacteria such as Bifidobacterium pseudolongum¹².

A role for probiotics?
Given the role of the gut microbiota in metabolic disorders, targeted probiotic formulations may be clinically relevant for optimizing metabolic health and influencing insulin resistance and low-grade inflammation associated with early- and late-stage low-grade metabolic disorders, specifically T2DM. Recent literature supports the efficacy of probiotics for improving a range of metabolic markers, including HOMA-IR, (a measure of insulin resistance), and serum LPS, (a measure of gut permeability and a trigger of inflammatory responses)^13–16. Furthermore, meta-analyses of probiotic interventions^17,18 as well as a faecal transplantation study¹² show that these interventions can be effective in T2DM.

Ecologic® Barrier for Metabolic Health
Ecologic® Barrier for Metabolic Health is a multispecies probiotic developed to optimize barrier function and reduce systemic low- grade inflammation¹⁵. Since 2017, a series of randomized, double-blind, placebo-controlled studies have established the value of Ecologic® Barrier’s value in improving metabolic health.

Ecologic® Barrier can make a meaningful difference in lives during the different stages of the diabetes journey by supporting efforts in maintaining a balanced diet and lifestyle and ultimately help to keep blood glucose levels under control.