Open AccessGut microbiome differences between metformin‐ and liraglutide‐treated T2 DM subjects
Author(s) -
Wang Zhang,
Saha Somdutta,
Van Horn Stephanie,
Thomas Elizabeth,
Traini Christopher,
Sathe Ganesh,
Rajpal Deepak K.,
Brown James R.
Publication year - 2018
Publication title -
endocrinology, diabetes and metabolism
Language(s) - English
Resource type - Journals
ISSN - 2398-9238
DOI - 10.1002/edm2.9
Subject(s) - akkermansia , metformin , liraglutide , microbiome , type 2 diabetes , diabetes mellitus , medicine , gut flora , endocrinology , glucose homeostasis , biology , lactobacillus , pharmacology , immunology , bioinformatics , bacteria , insulin resistance , genetics
Metformin and glucagon‐like peptide‐1 ( GLP ‐1) agonists are widely used for treating type two diabetes mellitus (T2 DM ). While recent studies suggest these drugs might modify the gastrointestinal tract ( GIT ) microbiome, further confirmation is required from human clinical trials. Materials and methods Here, we compare, in patients with T2 DM , the effects of metformin (n = 18 subjects) and liraglutide (n = 19), a GLP ‐1 agonist, on their GIT microbiomes over a 42 day period (n = 74 samples) using 16S ribosomal RNA ( rRNA ) sequencing. Results We found that these drugs had markedly different effects on the microbiome composition. At both baseline and Day 42, subjects taking metformin had a significant increase (Baseline adj. P = .038, Day 42 adj. P = .041) in the relative abundance of the bacterial genus Sutterella , whereas liraglutide dosing is associated with a significant increase (Baseline adj. P = .048, Day 42 adj. P = .003) in the genus Akkermansia , a GIT bacteria positively associated with gut barrier homoeostasis. Bacteroides and Akkermansia relative abundances were also significantly associated with duration of subject diabetes (adj P < .05). Specifically, there was a significantly higher abundance of Akkermansia in subjects with short and medium durations than those with long duration of diabetes. Discussion To our knowledge, this is the first report of GLP ‐1 agonist‐associated changes in the human microbiome and its differentiating effects to metformin. Our study suggests that modulation of the GIT microbiome is a potentially important component in the mechanism of action of these drugs.