Podcast Episode 168: The Gut Microbiome & Type 2 Diabetes – Dr. Orville Kolterman and Kristin Neusel

Disclosure: This episode is sponsored by Pendulum Therapeutics, the developer and manufacturer of the medical probiotic Pendulum Glucose Control. We thank them for their sponsorship and support of the podcast.

Alterations of the Gut Microbiome Are Associated with Type 2 Diabetes

Type 2 diabetes is a disease with genetic components and a disordered microbiome, not simply the consequence of laziness and dietary indiscretion. In respect for those afflicted, we need to abolish that stigma.” – Dr. Orville Kolterman

An expanding body of evidence demonstrates that beyond the known organs that are impacted by dysglycemia, insulin resistance and chronic inflammation, such as the pancreas, liver, and muscles, there are also pathophysiologic changes that occur in the gut microbiome. These changes appear in people who have been diagnosed with type 2 diabetes or who are on the path to developing type 2 diabetes (such as being diagnosed with prediabetes). Research is showing that these changes may be caused by a decrease in specific gut bacteria. This podcast offers listeners a deeper understanding of the changes that occur in the gut microbiome and how certain food choices and eating patterns, along with the use of a novel probiotic, can potentially improve glucose and A1c levels. Guests on this show include a renowned endocrinologist who has spent his career in diabetes care and research focused on the role of the gut in diabetes management, and a registered dietitian nutritionist and certified diabetes care and education specialist well versed in this science, probiotics and the nutrition management of type 2 diabetes.

Tune in to this episode to learn about:

• the pathophysiologic changes that occur in the gut microbiome of people with type 2 diabetes, including the role of butyrate, a short chain fatty acid, in the glucagon-like peptide 1 (GLP-1) physiologic pathway
• the beneficial functions of the gut bacteria that may be missing in the gut microbiomes of people with or developing type 2 diabetes
• the food and nutrition changes people with early diagnosed type 2 diabetes can make to increase their intake of a broad spectrum of dietary fibers, particularly those containing or leading to the production of short chain fatty acids
• the science and evidence for the use of a specific probiotic to assist with the dietary management of type 2 diabetes

Dr. Orville Kolterman, MD

Dr. Kolterman received his undergraduate degree from the University of Kansas followed by his MD degree and training as an endocrinologist at Stanford University. He served on the faculty at the University of Colorado School of Medicine and the University of California School of Medicine, San Diego. Dr. Kolterman joined Amylin Pharmaceuticals in 1992 where he served in various capacities and led teams that developed and gained regulatory approval for 4 first-in-class therapies for type 1 and type 2 diabetes and partial lipodystrophy. He has served as Chief Medical Officer at Pendulum Therapeutics since 2013.

Type 2 diabetes is a complex disease that includes decreased insulin secretion and insulin resistance. Recently, it has been demonstrated that community of bacteria that inhabit the intestinal tract in those individuals is missing key members that play critical roles in digesting dietary fiber. A recent study has shown that when those missing bacteria are replaced via administration of a well-characterized medical probiotic, metabolic control is improved.” – Dr. Orville Kolterman

Kristin Neusel, MS, RD, LD, CDCES

Kristin completed her undergraduate in Human Nutrition & Dietetics with a minor in Spanish, and she went on to obtain her Master of Science degree in Dietetics. She first started out as a Clinical Dietitian providing medical nutrition therapy on a variety of disease states. From there, she worked in the pharmaceutical industry as a Senior Clinical Educator and Medical Science Liaison, helping patients with rare and ultra-rare genetic diseases. Having worked closely with homozygous familial hypercholesterolemia and generalized lipodystrophy, her nutritional emphasis is on diabetes and lipid management. She helped create the nutrition education materials and programs for these patients, improving patient adherence, engagement, and satisfaction. As a Registered Dietitian and Certified Diabetes Educator, Kristin has a true passion for health, wellness, and helping patients reach their nutritional goals and making learning about nutrition FUN!

I believe that nutrition should be about adding things to the diet and not subtracting them. I am a firm believer in intuitive eating and finding what works best for you as an individual to have a healthy relationship with food!” – Kristin Neusel

Resources:

• Research study: Perraudeau F, McMurdie P, Bullard J, et al. Improvements to postprandial glucose control in subjects with type 2 diabetes: a multicenter, double blind, randomized placebo-controlled trial of a novel probiotic formulation. BMJ Open Diabetes Research and Care. 2020;8:e001319. doi: 10.1136/bmjdrc-2020-001319.
• Blog post: A straightforward guide to our published clinical study – by Hope Warshaw, MMSc, RD, CDES
• Orville Kolterman on LinkedIn
• Kristin Neusel on LinkedIn
• More about Kristin Neusel
• Pendulum Therapeutics: Website | Blog/Digest | Our Story | The Science | FAQs
• About Pendulum Glucose Control – medical probiotic
• Kristin Neusel’s blog posts on Pendulum’s Digest
• Related Research:
  • Herrema H. Niess JH. Intestinal microbial metabolites in human metabolism and type 2 diabetes. Diabetologia. 2020;63:2533-2547. (open access)
  • Davidson P, Davidson D, Loesch J, Limgrover A. The Therapeutic optimization of the gut microbiota in diabetes management. ADCES in Practice. 2020;8(3):26-31.
  • Kumar Singh A, Cabral C, Kumar R, et al. Beneficial effects of dietary polyphenols on gut microbiota and strategies to improve delivery efficiency. Nutrients. 2019;11(9):2216.
  • Zhao L, Zhang F. Ding X, et.al. Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes. Science. 2018;359:1151.
  • Singh RK, Chang HW, Yan D, et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017;15(1):73-90.

Related Posts:

Digestive Health: Probiotics, Prebiotics & Fermentation – Podcast Episode #162 with Dr. Elieke Kearns

Probiotics, Gut Health & Infants – Podcast Episode #124 with Dr. Anthony Thomas

Diabetes & Heart Health: New Research on Lean Beef – Podcast Episode #154 with Dr. Kevin Maki

Diabetes Self Care Behaviors: An Update – Podcast Episode #147 with Molly McElwee-Malloy

Prediabetes: Risks, Reversal & Lifestyle Reset – Podcast Episode #125 with Jill Weisenberger

Refined Grains & Diabetes – Guilt By Association? – Podcast Episode #120 with Dr. Glenn Gaesser

Decreasing the Cultural Distance in Diabetes – Podcast Episode #114 with Constance Brown-Riggs

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Music by Dave Birk

Produced by JAG in Detroit Podcasts

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