When you hear the words ‘type 2 diabetes’ or ‘metabolic syndrome’, do you think of your digestive tract? You’re right; it’s probably not the first thing that pops into your head. You probably think of high blood sugar or obesity first, right? A new study suggests that the lining of the intestines in our digestive tract may tell us more about diabetes and metabolic syndrome than high blood sugar and obesity.
Type 2 Diabetes and Metabolic Syndrome
Before we dive into what the study showed, let’s get some background information first. Insulin is secreted from our pancreas after we eat to help balance blood sugar levels. It does this by transporting glucose from our bloodstream into our cells. In Type 2 Diabetes there is insulin insensitivity, which means that our body doesn’t listen to the signal from insulin and therefore can’t transport the glucose from the food we ate into the cells to be used as energy. As a result, we have high amounts of blood glucose which, in the long term, can lead to vision loss, difficulty healing wounds, and kidney problems just to name a few. Metabolic syndrome on the other hand is a group of conditions including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance.1 This cluster of conditions leads to an increased risk for other health conditions such as cardiovascular disease.1
What does our gut have to do with it?
Now you’re probably wondering why the heck I explained all of that. Well, Type 2 Diabetes and metabolic syndrome are both very common and lead to many negative health consequences. That’s why I was so excited to find this article connecting hyperglycemia (increased levels of blood glucose) and our gut microbiome. It provides a different approach to how we look at and potentially treat these two conditions. As I said before, this study suggests that the interaction between the lining of our intestines and gut microbiome affect these two conditions.2 Our gut microbiome is composed of trillions of bacteria that research is showing can have an effect on our immune system, our digestion, and our brain. Now inside our intestines there is a protective mucosal barrier that separate the gut microbiome from the intestines themselves. When that protective barrier breaks down, the bacteria start to move closer to the cells of the intestinal lining . What this study found was that the closer the gut bacteria of the microbiome moves toward the lining of the intestine, the more likely the person is to have inflammation, and conditions related to inflammation like irritable bowel syndrome, and hyperglycemia leading to Type 2 Diabetes and metabolic syndrome.
What does this mean?
One of the most interesting findings was that the distance between the bacteria and intestinal cells were closer together in those with risk factors of Type 2 Diabetes and metabolic syndrome (overweight or obese, increased fasting blood glucose levels and hemoglobin A1c concentrations).2 In healthy (non-obese or non-diabetic) subjects, the distance between the bacteria and intestinal cells were further apart.2 This means that we could potentially determine a persons risks based on the distance between the bacteria and the intestinal cells. They even found that this distance may be a better indicator of hyperglycemia than BMI. Currently, body mass index (BMI; kg/m2) is a way to measure a person’s weight compared to their height.3 According to the BMI scale, being 25-30 kg/m2 is considered overweight and >30 kg/m2 is considered obese.3
Is it glucose’s fault?
The real question is what came first – the chicken or the egg? Do increased glucose levels cause the gut bacteria to move closer to the intestinal cells or does this decreased distance lead to insulin resistance? Based on their findings, the authors determined that a short-term increase in blood glucose would not affect the protective barrier in our intestines.2 Instead, the bacterial interaction with the intestinal cells may cause chronic low-grade inflammation which could potentially lead to insulin resistance seen in both Type 2 Diabetes and metabolic syndrome.2 More studies need to be done but the idea that we can treat, or better yet prevent, Type 2 Diabetes and metabolic syndrome by focusing on gut health is really promising!
What can you do?
I think it goes without saying that making sure our gut health top notch is really important to overall health. First and foremost, this means eating a nutrient dense diet, rich in polyphenols, fermented foods and low in sugar and other processed foods. Not only does this support your gut, but it also decreases inflammation and protects against insulin resistance.
- Srikanthan, K., Feyh, A., Visweshwar, H., Shapiro, J. I., & Sodhi, K. (2016) Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification in the West Virginian Population. International Journal of Medical Sciences, 13(1), 25–38. https://doi.org/10.7150/ijms.13800
- Chassaing, B., Raja, S. M., Lewis, J. D., Srinivasan, S., & Gewirtz, A. T. (2017). Colonic Microbiota Encroachment Correlates With Dysglycemia in Humans. Cellular and Molecular Gastroenterology and Hepatology, 4(2), 205–221. https://doi.org/10.1016/j.jcmgh.2017.04.001
- National Heart, L. and B. I. (n.d.). Calculate Your BMI. Retrieved June 13, 2017, from https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm