My last post dealt with a patient with both diabetes and CFS. There are likely more patients with that combination. Today, I am going to try to assemble what I can from PubMed on diabetes and the microbiome (without CFS — I suspect studies of that combination are none existent). This is an area of growing interest in the last few years:
- “Oral microbiota is also correlated with many systemic diseases, including cancer, diabetes mellitus, rheumatoid arthritis, cardiovascular diseases, and preterm birth. ”  See Oral Probiotics post as well an hydrogen peroxide, etc mouth rinses
- Typically, I waterpic my teeth at night, rinse with a germ killing mouth wash and then go to sleep with a oral probiotic in the mouth…
- “The co-occurrence of the three disease entities, inflammatory bowel disease (IBD), colorectal cancer (CRC), type 2 diabetes mellitus (T2DM) along with inflammation and dismicrobism has been frequently reported.” 
- “Type 2 diabetes (T2D) is associated with dysbiosis of the gut microbiota, though diabetes treatment regimens, including metformin, may confound the results.” 
- “The present analysis showed, for the first time, a limited association between Functional gastrointestinal disorders and T2D risk in a large prospective cohort, and supports the hypothesis of a relationship between gastrointestinal function and diabetes” 
- Clostridium butyricum attenuates cerebral ischemia/reperfusion injury in diabetic mice via modulation of gut microbiota.  – thumbs up for Miyarisan!
- ” L. brevis DPC 6108 attenuated hyperglycaemia induced by diabetes” 
- “S. aureus was isolated in 72 % of culture-positive samples, whereas the most commonly detected bacteria in all ulcers were Peptoniphilus spp., Anaerococcus spp. and Corynebacterium spp., with the addition of Staphylococcus spp. in new ulcers.”[diabetic foot ulcers, 2016]
- “We found changes both in composition and in function of the sub-clinical gut microbiome, including a decrease in Akkermansia muciniphila suggesting a role prior to the onset of [diabetes] disease,” 
- “. Additionally, microbiomeanalysis demonstrated that composition of lean-inducible bacteria was increased after bicarbonate-rich mineral water consumption. Our results suggested that consumption of BMW has the possible potential to prevent and/or improve type 2 diabetes through the alterations of host metabolism and gut microbiota composition.” 
- “The five most abundant phyla identified were: Bacteroidetes, Firmicutes, Proteobacteria, Verrucomicrobia, and Actinobacteria. Class Chloracido bacteria was increased in preDM compared to T2DM (p = 0.04). An unknown genus from family Pseudonocardiaceae was significantly present in preDM group compared to the others (p = 0.04). Genus Collinsella, and an unknown genus belonging to familyEnterobacteriaceae were both found to be” 
- ” The gut microbiota in individuals with preclinical Type 1 diabetes mellitus is characterized by Bacteroidetes dominating at the phylum level, a dearth of butyrate-producing bacteria, reduced bacterial and functional diversity and low community stability.” 
- Gut microbiota: Antidiabetic drug treatment confounds gut dysbiosis associated with type 2diabetes mellitus. 
- “Specifically, lower stool Bacteroidaceae, Clostridiales XIV, Lachnospiraceae, Ruminococcacae and higher Enterococcaceae and Enterobacteriaceae were seen in hospitalized patients.” 
- ” We provide support for microbial mediation of the therapeutic effects of metformin through short-chain fatty acid production, as well as for potential microbiota-mediated mechanisms behind known intestinal adverse effects in the form of a relative increase in abundance of Escherichia species. Controlling for metformin treatment, we report a unified signature of gut microbiome shifts in T2D with a depletion of butyrate-producing taxa. These in turn cause functional microbiome shifts, in part alleviated by metformin-induced changes. Overall, the present study emphasizes the need to disentangle gut microbiota signatures of specific human diseases from those of medication.”  again Miyarisan is implied.
- ” Microbiota in the samples was predominantly represented by Firmicutes, in a less degree by Bacteroidetes. Blautia was a dominant genus in all samples. The representation of Blautia, Serratia was lower in preD than in T2D patients, and even lower in those with normal glucose tolerance.” Blautia was formerly part of Ruminococcus until DNA analysis found that they were different see this 2008 article or this 2013 PDF
The most interesting take-away was the use of bicarbonate-rich mineral water. This is actual clinical study confirmation of the health-loosing aspect of using soft water (see this post). The details of the water (from Japan) (Bicarbonate ion, 2485 mg/kg (i.e. per litter) – roughly 100x higher than in tap water. Second, CFS/FM/IBS has an increase diabetes risk (and likely also cancer risk – the latter may be connected with low Vitamin D levels). Third, the typical medication used for diabetes increases E.Coli and alters the microbiome, but not necessarily the right strains.
Last, there appear to be specific families (for example Blautia) that may be strongly associated with diabetes risk.