Sondra was standing confused by the glucometer isle. She was looking for affordable and reliable device . Yesterday , her doctor recommended buying and starting to monitor sugar levels at home. Sondra was told that metformin had to be replaced with injectable insulin. She felt a wave of despair and disappointment . How come the medication did not work?
She followed every word of advice ever since she found out a year ago that her fatigue and weight problems had a lot to do with blood sugar. She thought she ate right. She renewed gym membership and started her day at 6 AM on treadmill every day before work. And all that in vain, like she did nothing but sat on a couch, snacking on chips and chocolate chip cookies.
Deep down, she suspected that everything might not be so all right. She did not have glucometer but had her Buddy.
Sondra lived alone in a small trailer before Buddy came to her . A friend suggested she gets a dog to keep her company after her husband died. At first Sondra thought it was one crazy idea and most of all -very expensive one. But her friend would not give up and suggested dog adoption from a shelter. Under the pressure , Sondra gave in and one Saturday morning visited dog shelter with open mind and an open heart. And there, in a cage, on a shabby brown woolen blanket, curled up, Buddy was resting. Their eyes met , his full of fear ,hers full of sympathy .The connection was instant and Buddy was with her in the trailer that same night.
He was very timid. Every time Sondra would take a broom to swipe the floor, Buddy would run into the corner and try to hide away.
“Come here old boy,” Sondra would call him .
“If he could only speak,” she would think to herself. She thought that the dog was beaten, maybe with the broom, in his old home. Why would he react to it with so much fear?
But as the time passed, they became good friends.
Sondra marveled at his intelligence, but even more his sixth sense. Every time she would not feel well, Buddy would be by her side, paw her legs, jump on her lap, pull her skirt to alert her to take her medications.
“Are you trained service dog?”, she would ask him over and over again.
Service dogs are known to be able to sense medical crisis in his owner. Sondra was counting on Buddy to be her live glucometer.
Sondra is not the only diabetic wondering why her sugar is not well controlled when she was doing everything in her power to tame it. Maybe it is not all only about diet and exercise.
New scientific data are looking at gut microbiota and metabolic diseases. There is growing evidence that altered gut microbiota may influence insulin resistance . The mechanisms of action of the intestinal microbiome on metabolism are still not fully understood, but researchers are looking at inflammation, innate immune system and quality of intestinal barrier. Most of the studies have used animal model for research.
Obesity and diabetes are the components of metabolic syndrome . Studies have demonstrated difference in gut microbial composition between obese and lean individuals in favor of pro inflammatory bacteria ,such as Bacteroides and Proteobacteria .Butyrate producing bacteria, such as Faecalibacterium prausnitzii may have protective role against diabetes type 2.
Dysbiosis or a state of altered microbial composition in the gut ,plays a role in creation of low grade chronic inflammation which is also part of the metabolic syndrome.
Gut microbiota produce short chain fatty acids (SCFA) from fermentation of fiber and promote healthy intestinal lining . In one study researchers discovered that patients who had abundance in diversity of bacteria that produce SCFA had better levels of hemoglobin A1 c than the group with less bacterial diversity. Targeted increase in SCFA producers via increasing dietary fiber may be in future focus of research.
Recently published research reported effects of glucose lowering agents on gut microbes by influencing levels of cytokines or production of fatty acids.
Manipulation of gut microbiota with dietary changes, prebiotics and probiotics with intent to control metabolic disease is still to be fully understood by scientists.
Maybe it is not all about diet and exercise, Sondra thought to herself and added a packet of probiotics to her cart. She decided to monitor her blood glucose as she starts to take probiotics and feed the microbial diversity to her gut.
- Microbiota and Metabolic Disease Pascale A et al Endocrine 2018 May 2
- The Relationship between Frequently Used Glucose Lowering Agents and Gut Microbiota in Type 2 Diabetes Mellitus Lv Y et al J Diabetes Res 2018 May 7
- Targeting Gut Microbiota as a possible therapy for diabetes He C ET AL Nutr Res 2015 May 35 (5) 361-7
- The gut micro biome as a target for prevention and treatment of hyperglycemia in type 2 diabetes :from current human evidence to future possibilities Brunkwall et al Diabetologia 2017 Jun (6) 943-951
- Assessing the human gut microbiota in metabolic diseases Karlsson et al Diabetes 2013 Oct 62 3341-9