Tuesday, December 1, 2015

Antibiotics and Risk for Diabetes by David Perlmutter, MD

Antibiotics and Risk for Diabetes
If you’ve been following the microbiome story you are likely aware of the emerging literature that squarely places gut bacteria in a pivotal position as it relates to any number of physiological processes. From regulating the balance of the immune system to determining the level of inflammation that a person may experience, it is now becoming mainstream knowledge that our gut bacteria are poised to regulate our most critical, life-supportive processes.
In Brain Maker, and certainly on this blog, I have written extensively on the important role of the microbiome in terms of regulating blood sugar and insulin sensitivity. As such, we would expect that environmental events that disrupt the gut ecology might have a causative role, or at least show correlation with type 2 diabetes.
Recall that several months ago I called attention to the interesting study from Israeli researchers in which changes to the gut bacteria brought on by exposure to artificial sweeteners were dramatically associated with increased risk for issues related to glucose regulation, insulin sensitivity, and, therefore, type II diabetes.
You might therefore expect, based upon your understanding of this relationship between the gut bacteria and regulation of blood sugar, that there might be a correlation between risk of type 2 diabetes and exposure to antibiotics. Antibiotics, while representing a powerful medical modality for a variety of bacterial infections, nonetheless dramatically affect the array of bacteria within the gut, for the most part negatively.
That said, a new study has in fact revealed a dramatic relationship between antibiotics exposure and risk of type 2 diabetes. The research, carried out in Denmark, correlated the development of type II diabetes with antibiotic exposure in a review of 5.6 million individuals over a 12-year period of time. The results of the study clearly related risk for developing diabetes to the degree of antibiotic exposure an individual experienced. Over the course of the study, risk of type 2 diabetes was increased by 53% in individuals receiving antibiotics of any type.
In their conclusion, the authors stated:
There is now mounting evidence from rodent models suggesting that antibiotics may drive changes in insulin sensitivity, glucose tolerance, lipid deposition, and energy harvesting potential by altering the gut microbiota composition.
For the record, I again want to state that antibiotics play an important role in healthcare. At times they are life-saving treatments for individuals experiencing bacterial infections.
It is clear however that we are dramatically overusing antibiotics. In fact, the World Health Organization has now indicated that over usage of antibiotics represents one of the top three global health threats of this decade.
Further, recognize that at least 80% of the antibiotics sold in America are actually used in livestock and poultry, whereby exposure to antibiotics makes animals gain weight, much as they do in humans. According to a recent publication in Consumer Reports, this misguided use of antibiotics represents a clear and present danger to humans.
With this new research, we are seeing a powerfully strong correlation between antibiotic exposure and risk of developing type II diabetes. So the take-home message is to think twice before you take an antibiotic the next time you have a cold or sore throat. Chances are, if you if you walk into a clinic with a cold, you will walk out with a prescription for an antibiotic. But please understand, well-respected, peer-reviewed scientific publications are now making it quite clear that taking an antibiotic is not a free ride.
Take care of your microbiome!
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