Inside Scoop: How Your Gut Microbiome is Tied to Diabetes

Your diet can impact your health by regulating the makeup of your gut microbiome. Research shows that the gut microbiome can affect the immune system, nutrient absorption, tissue development, and bone health. As a result, a balanced diet plays a crucial role in controlling microbial populations and preventing, managing, and treating lifestyle-related diseases like diabetes.

What is diabetes and how common is it? 

The human body produces insufficient insulin, a hormone that regulates blood sugar levels, or does not respond properly to insulin, resulting in elevated blood sugar levels, in a condition called diabetes. Diabetes has three main types: Type 1, usually inherited and cannot be prevented; Type 2, the most prevalent type and can be prevented; and gestational, which occurs during pregnancy.

The incidence of diabetes is increasing gradually in Singapore, with one out of seven Singaporeans at risk. In 2014, around 440,000 Singapore residents aged 18 years and above had diabetes, and this number is predicted to increase to 1,000,000 by 2050. Diabetes was the 4th most frequent condition of polyclinic attendances and 8th most common for hospitalizations in 2014. In 2010, diabetes was responsible for the 4th largest loss of life years due to mortality and ill-health among all diseases. The cost burden of diabetes, including medical expenses and productivity loss, is expected to surge from over $940 million in 2014 to $1.8 billion in 2050.

What’s the link between diabetes and the gut microbiome?

The gut microbiome, which consists of microbes in the gastrointestinal tract, can affect various aspects of health, including immunity, metabolism, and energy extraction from food. Studies have shown that the gut microbiome can impact the development of chronic diseases, including type 2 diabetes.

In preclinical animal models and healthy animals, the gut microbiome has been linked to glucose metabolism. High-fat diets are notoriously associated with substantial compositional changes in the gut microbiome, including reductions in both Gram-positive (e.g., Bifidobacterium spp.) and Gram-negative bacteria (e.g., Bacteroides).

A better diet with appropriate dietary adherence can improve insulin sensitivity and glycemic control, playing an important role in diabetes prevention. There is no single ‘gut healthy’ diet, but having a balanced diet that predominantly consists of a wide range of foods that are plant-based, high in fiber, or probiotic will promote a healthy gut with a diverse community of microbes, specifically healthy gut bacteria. This keeps your inner gastrointestinal ecosystem in shape.


What can I eat to keep my gut in check? 

Healthy Carbs: Include healthy carbohydrates such as fruits, vegetables, whole grains, legumes, and low-fat dairy products in your diet, while avoiding less healthy carbs with added fats, sugars, and sodium.

Fibre-rich Foods: Eat fibre-rich foods like vegetables, fruits, nuts, legumes, and whole grains to promote satiety and control blood sugar levels.

Heart-healthy Fish: Consume heart-healthy fish like salmon, mackerel, tuna, or sardines twice a week, but avoid fried fish and those with high mercury levels.

Healthy Fats: Incorporate healthy fats like olive oil, canola oil, nuts, and avocados into your diet, but watch your portion sizes.

Probiotics: Probiotics found in foods like yogurt, sauerkraut, tempeh, kimchi, miso, kombucha, pickles, and some cheeses can help populate your gut microbiome with various strains of bacteria.

While a healthy diet is crucial for gut health, lifestyle changes are also important for preventing diabetes.


What else can I do?  

Avoid smoking. Smoking can harm your digestive system and affect the composition of your gut microbiome. Smoking can make certain conditions harder to treat and increases your risk for Crohn’s disease and gallstones.

Get moving! Aim for at least 150 minutes of exercise at moderate intensity per week. A good gauge for moderate intensity is the level where you can have a conversation but are unable to sing.

Put down the bottle! Alcohol consumption places additional stress on the liver, which is responsible for metabolising alcohol.  Several studies suggest that systemic inflammation, like that caused by alcohol-provoked leaky gut, can influence the nervous system in several ways. If you drink alcoholic beverages, do so in moderation. A standard alcoholic drink is defined as a can (330 ml) of regular beer, half a glass (100 ml) of wine or 1 nip (30 ml) of spirit.