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Randomized Controlled Trial
. 2017 Jul;23(7):850-858.
doi: 10.1038/nm.4345. Epub 2017 May 22.

Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug

Hao Wu  1 , Eduardo Esteve  2   3   4 , Valentina Tremaroli  1 , Muhammad Tanweer Khan  1 , Robert Caesar  1 , Louise Mannerås-Holm  1 , Marcus Ståhlman  1 , Lisa M Olsson  1 , Matteo Serino  5 , Mercè Planas-Fèlix  6 , Gemma Xifra  2   3   4 , Josep M Mercader  6 , David Torrents  6   7 , Rémy Burcelin  8   9 , Wifredo Ricart  2   3   4 , Rosie Perkins  1 , José Manuel Fernàndez-Real  2   3   4 , Fredrik Bäckhed  1   10   11
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Randomized Controlled Trial

VSports - Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug

Hao Wu et al. Nat Med. 2017 Jul.

Abstract

Metformin is widely used in the treatment of type 2 diabetes (T2D), but its mechanism of action is poorly defined. Recent evidence implicates the gut microbiota as a site of metformin action. In a double-blind study, we randomized individuals with treatment-naive T2D to placebo or metformin for 4 months and showed that metformin had strong effects on the gut microbiome VSports手机版. These results were verified in a subset of the placebo group that switched to metformin 6 months after the start of the trial. Transfer of fecal samples (obtained before and 4 months after treatment) from metformin-treated donors to germ-free mice showed that glucose tolerance was improved in mice that received metformin-altered microbiota. By directly investigating metformin-microbiota interactions in a gut simulator, we showed that metformin affected pathways with common biological functions in species from two different phyla, and many of the metformin-regulated genes in these species encoded metalloproteins or metal transporters. Our findings provide support for the notion that altered gut microbiota mediates some of metformin's antidiabetic effects. .

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