Impact of intensive lifestyle intervention on gut microbiota composition in type 2 diabetes: a post-hoc analysis of a randomized clinical trial

• Published in: Gut microbes Vol. 14; no. 1; p. 2005407
• Main Authors: Wei, Shaodong, Brejnrod, Asker Daniel, Trivedi, Urvish, Mortensen, Martin Steen, Johansen, Mette Yun, Karstoft, Kristian, Vaag, Allan Arthur, Ried-Larsen, Mathias, Sørensen, Søren Johannes
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.01.2022; Taylor & Francis Group
• Subjects: Adult; Bacteria - classification; Bacteria - genetics; Bacteria - isolation & purification; Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - diet therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - microbiology; Diabetes Mellitus, Type 2 - psychology; Diet; Exercise; Feces - microbiology; Female; Follow-Up Studies; Gastrointestinal Microbiome; gut microbiota; Humans; Life Style; lifestyle intervention; Male; metformin; Middle Aged; physical activity; Research Paper; standard care; type 2 diabetes; type 2 diabetes; exercise; metformin; gut microbiota; lifestyle intervention; standard care; physical activity
• ISSN: 1949-0976; 1949-0984
• DOI: 10.1080/19490976.2021.2005407

Type 2 diabetes (T2D) management is based on combined pharmacological and lifestyle intervention approaches. While their clinical benefits are well studied, less is known about their effects on the gut microbiota. We aimed to investigate if an intensive lifestyle intervention combined with conventional standard care leads to a different gut microbiota composition compared to standard care alone treatment in individuals with T2D, and if gut microbiota is associated with the clinical benefits of the treatments. Ninety-eight individuals with T2D were randomized to either an intensive lifestyle intervention combined with standard care group (N = 64), or standard care alone group (N = 34) for 12 months. All individuals received standardized, blinded, target-driven medical therapy, and individual counseling. The lifestyle intervention group moreover received intensified physical training and dietary plans. Clinical characteristics and fecal samples were collected at baseline, 3-, 6-, 9-, and 12-month follow-up. The gut microbiota was profiled with 16S rRNA gene amplicon sequencing. There were no statistical differences in the change of gut microbiota composition between treatments after 12 months, except minor and transient differences at month 3. The shift in gut microbiota alpha diversity at all time windows did not correlate with the change in clinical characteristics, and the gut microbiota did not mediate the treatment effect on clinical characteristics. The clinical benefits of intensive lifestyle and/or pharmacological interventions in T2D are unlikely to be explained by, or causally related to, changes in the gut microbiota composition.