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Altering the Gut Microbiome to Improve Tolerability of Metformin
Author(s) -
Johnson Matthew,
Burton Jeffrey,
Greenway Frank,
Heiman Mark
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.914.3
Subject(s) - metformin , medicine , tolerability , flatulence , type 2 diabetes , placebo , gastroenterology , discontinuation , diabetes mellitus , gastric emptying , pharmacology , endocrinology , insulin , adverse effect , stomach , alternative medicine , pathology
Although metformin is the drug of choice for managing type 2 diabetes, its wide range of negative gastrointestinal side effects can lead to intolerability and discontinuation. A case study from 2012 suggested that administering certain gut microbiome modulators (GMM) composed of inulin, beta‐glucan, and blueberry extract (NM‐504) to a metformin‐intolerant patient reduced gastrointestinal side effects to the point of rendering metformin tolerable. A cross‐over trial was done on ten metformin‐intolerant, type 2 diabetic patients in order to test this hypothesis. The group was randomized to metformin plus NM‐504 (GMM) or a placebo for two weeks, followed by a two week washout, and concluded with two weeks being administered the opposite treatment received in the first two weeks of the trial (NM‐504 or placebo). Fasting blood glucose and gastrointestinal side effects were monitored via glucose self‐monitoring and a written survey, respectively. A mixed model analysis (ANOVA) was performed to determine treatment effects on gastrointestinal side effects and fasting glucose levels. NM‐504 was found to significantly reduce (p < .05) gastrointestinal urgency, bloating, and flatulence frequency in subjects. Additionally, NM‐504 significantly lowered fasting glucose levels in conjunction with the largest dose of metformin (p < .05). In conclusion, taking the GMM (NM‐504) and metformin concurrently improved metformin tolerability in metformin‐intolerant type 2 diabetic subjects.