Gut microbiota, behavior, and nutrition after type 1 diabetes diagnosis: A longitudinal study for supporting data in the metabolic control

Deborah Traversi; Giacomo Scaioli; Ivana Rabbone; Giulia Carletto; Arianna Ferro; Elena Franchitti; Deborah Carrera; Silvia Savastio; Francesco Cadario; Roberta Siliquini; Franco Cerutti; Marilena Durazzo

doi:10.3389/fnut.2022.968068

Gut microbiota, behavior, and nutrition after type 1 diabetes diagnosis: A longitudinal study for supporting data in the metabolic control

Front Nutr. 2022 Dec 6:9:968068. doi: 10.3389/fnut.2022.968068. eCollection 2022.

Authors

Affiliations

¹ Department of Public Health and Pediatrics, University of Turin, Torino, Italy.
² S.S.V.D. Endocrinology and Diabetology, O.I.R.M., Azienda Ospedaliera Città della Salute e della Scienza, Turin, Italy.
³ Department of Health Science, Azienda Ospedaliero Universitaria Maggiore della Carità, University of Eastern Piedmont Amadeo Avogadro, Novara, Italy.
⁴ S.C.U. Medicina Interna 3, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.
⁵ Paediatric Endocrinology, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.

Abstract

Introduction: Type 1 diabetes (T1D) risk involves genetic susceptibility but also epigenetics, environment, and behaviors. Appropriate metabolic control, especially quickly after the diagnosis, is crucial for the patient quality of life.

Methods: This study aimed to produce a quantitative comparison of the behavior, nutrition habits, and gut microbiota composition between the onset and the 1-year follow-up in 35 children with T1D.

Results and discussion: At follow-up, with the metabolic control, many parameters improved significantly, with respect to the onset, such as glycated hemoglobin (-19%), body mass index (BMI), and also nutritional behaviors, such as normal calorie intake (+6%), carbohydrate intake (-12%), extra portion request (-4%), and meals distribution during the day. Moreover, glycated hemoglobin decrement correlated with both total and rapid absorption carbohydrate intake (Spearman's rho = 0.288, 95% CI 0.066-0.510, p = 0.013), showing as the nutritional behavior supported the insulin therapy efficiency. The next-generation sequencing (NGS) analysis of microbiota revealed abundance differences for Ruminococcus bromii and Prevotella copri (higher at onset, p < 0.001) and the genera Succinivibrio and Faecalibacterium (lower at onset, p < 0.001), as a consequence of nutritional behavior, but it was not the only changing driver. The qRT-PCR analysis showed significant variations, in particular for Bacteroidetes and Bifidobacterium spp. (+1.56 log gene copies/g stool at follow-up, p < 0.001). During the year, in 11% of the patients, severe clinical episodes occurred (hypoglycemic or ketoacidosis). The likelihood of a severe hypoglycemic episode was modulated when the Methanobrevibacter smithii amount increased (odds ratio 3.7, 95% CI 1.2-11.4, p = 0.026). Integrated evaluation, including nutritional behavior and microbiota composition, could be considered predictive of the metabolic control management for children cohort with a recent diagnosis of T1D.

Keywords: Methanobrevibacter smithii; T1D progression; microbiota; type 1 diabetes; α-diversity.