Effects Of Metformin On The Composition Of Intestinal Flora In Newly Diagnosed Type 2 Diabetic Patients

Objective To study the effect of metformin on the composition of intestinal flora in newly diagnosed type 2 diabetic patients,and to explore the role of intestinal flora in the mechanism of metformin hypoglycemic,so as to provide reference for clinical treatment.Method From March 2019 to July 2019,thirty-two newly diagnosed type 2diabetic patients were included in the study,twenty patients who did not conform to the medication plan were excluded,eleven patients took metformin regularly for two weeks,a patient who had gastrointestinal tract maladjustment was excluded and a patient who withdrew from the study.Finally,three fecal samples were collected from ten patients before and after taking the metformin,sixty in total.We collected the basic information of patients before and after treatment,including: age,gender,BMI,fasting blood glucose,2 hours postprandial blood glucose.The method of high-throughput sequencing was used to analyze the intestinal flora in feces,and bioinformatics and statistical analysis were carried out.Result After taking metformin,the fasting blood glucose and 2 hours postprandial blood glucose of the newly diagnosed type 2 diabetic patients decreased significantly(P <0.05).Analysis of intestinal flora,the OTUs composition of intestinal flora with newly diagnosed type 2 diabetic patients changed,and the number of OTUs in species level decreased significantly(P<0.05).Before and after the treatment,the highest relative abundance of intestinal microflora of the two groups was found in the top 5 at phylum level including Firmicutes(63.5%),Actinobacteria(19.1%),Proteobacteria(10.5%),Bacteroides(6.1%),Vcrrucomicrobia(0.35%),at class level including Clostridiaand(55.4%),Actinobacteria(17.3%),Bacilli(13.1%),Bacteroidetes(7.5%)?Gammaproteobacteria(6.2%),the highest relative abundance of genus level include Bifidobacterium 16.4%,Blautia 13.9%,Faecalibacterium 10.6%,Roseburia10.4%,and Bacteroides 5.4%.After taking metformin,the relative abundance of Firmicutes increased(P <0.05)but Actinomycetes decreased(P<0.05)at the level of phylum.At the class level,the relative abundance of Clostridia increased(P<0.05),while that of Actinomycetes,Bacilli and Gammaproteobacteria decreased(P<0.05)and that of Bifidobacterium and Lactobacillus decreased(P<0.05)at the level of genus.After further analysis of the different species in the intestinal flora before and after treatment,it was found that the difference between the two groups marked the change of species.Before treatment,Actinobacteria,Bacilli,Lactobacilli,Lactobacilli are significantly different(P<0.05).After treatment,significantly different microfloras were Clostridial,Ruminococcaceae and Firmicutes(P<0.05).Conclusion 1.After taking metformin,the blood sugar of the newly diagnosed type 2 diabetic patients decreased significantly,and the composition of intestinal flora changed.2.After taking metformin,the relative abundance of short chain fatty acid producing bacteria increased in newly diagnosed type 2 diabetic patients,suggesting that intestinal flora may participate in the hypoglycemic effect of metformin.