Features of the gut microbiota metabolism and their relationship with the parameters of the lipid profile in patients with type 2 diabetes mellitus receiving tableted hypoglycemic therapy

   Introduction. Gut microbiota (GM) metabolism in patients with type 2 diabetes mellitus (T2DM) has a number of features, including changes in the functional characteristics of microorganisms and, as a result, changes in the levels of the main metabolites of GM – short-chain fatty acids (SCFA).

   The purpose of the study. To investigate the features of the SCFA in patients with T2DM receiving innovative hypoglycemic therapy combined with metformin.

  Materials and methods. The study included 80 patients with T2DM aged 45–60 years, with the duration of the disease to 5 years, HbA1c did not exceed 7.5 %, BMI was 27–35 kg/m². All patients received metformin and SGLT-2 inhibitors or metformin and DPP-4 inhibitors.

   Results. The median age of the patients was 55 [52-57] years, and the median duration of T2DM was 2 [1-4] years. The average BMI in the group was 31.22 ± 2.42 (95 % CI: 30.68–31.76) kg/m². The average HbA1c level – 6.16 ± 0.79 (95 % CI: 5.98–6.33) %. A significant decrease in the level of the amount of SCFA (3,664 [2,053–7,014] mg/g) was revealed compared with the people without T2DM (10.5 ± 1.5 mg/g). The absolute concentrations of acetic, propionic, and butyric acids are also almost threefold reduced (1.93 [0.95–3.99] mg/g, 0.82 [0.39–1.58] mg/g, 0.55 [0.30–1.31] mg/g). The anaerobic index was shifted towards sharply negative values and amounted to -0.76 ± 0.25 (95 % CI: from -0.81 to -0.70). There were no statistically significant differences between the treatment groups of patients.

   Conclusions. The data obtained highlight the unresolved problem of decompensation of the microbiotic link in the pathogenesis of T2DM.

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