Associations of disordered eating with the intestinal microbiota and short-chain fatty acids among young adults with type 1 diabetes

Background and aims: Disordered eating (DE) in type 1 diabetes (T1D) includes insulin restriction for weight loss with serious complications. Gut microbiota-derived short chain fatty acids (SCFA) may benefit host metabolism but are reduced in T1D. We evaluated the hypothesis that DE and insulin restriction were associated with reduced SCFA-producing gut microbes, SCFA, and intestinal microbial diversity in adults with T1D. Methods and results: We collected stool samples at four timepoints in a hypothesis-generating gut microbiome pilot study ancillary to a weight management pilot in young adults with T1D. 16S ribosomal RNA gene sequencing measured the normalized abundance of SCFA-producing in-testinal microbes. Gas-chromatography mass-spectrometry measured SCFA (total, acetate, buty-rate, and propionate). The Diabetes Eating Problem SurveydRevised (DEPS-R) assessed DE and insulin restriction. Covariate-adjusted and Bonferroni-corrected generalized estimating equa-tions modeled the associations. COVID-19 interrupted data collection, so models were repeated restricted to pre-COVID-19 data. Data were available for 45 participants at 109 visits, which included 42 participants at 65 visits pre-COVID-19. Participants reported restricting insulin At least sometimes at 53.3% of visits. Pre-COVID-19, each 5-point DEPS-R increase was associated with a-0.34 (95% CI-0.56,-0.13, p = 0.07) lower normalized abundance of genus Anaerostipes; and the normalized abundance of Lachnospira genus was-0.94 (95% CI-1.5,-0.42), p = 0.02 lower when insulin restriction was reported At least sometimes compared to Rarely or Never.Conclusion: DE and insulin restriction were associated with a reduced abundance of SCFA-producing gut microbes pre-COVID-19. Additional studies are needed to confirm these associa-tions to inform microbiota-based therapies in T1D. 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to evaluate the association between disordered eating and gut microbiota-derived short chain fatty acids (SCFA) in individuals with type 1 diabetes. The results showed that disordered eating and insulin restriction were associated with a reduced abundance of gut microbes that produce SCFA.