A little donated poop may go a long way for people with type 1 diabetes. New research published this week suggests that fecal microbiota transplantation (FMT) can help alleviate gastrointestinal issues in people with the chronic condition.
Researchers at Aarhus University Hospital in Denmark conducted the study—a small, randomized, double-blinded, and placebo-controlled trial of FMT in people with type 1 diabetes. Compared to the placebo group, people who received FMT experienced a significant reduction of their gastrointestinal symptoms, with no major complications. The results provide early evidence that FMT can be an effective add-on to people’s diabetes care, the researchers say.
Type 1 diabetes is an autoimmune condition characterized by the destruction of pancreatic cells that produce insulin. Without insulin, people’s blood sugar levels become chronically and dangerously high. Though people with diabetes can take synthetic insulin and other medications to manage their blood sugar, the condition still tends to raise people’s risk of other health problems, including gastrointestinal issues.
Some research has shown that the gut microbiomes of people with type 1 diabetes are markedly different than the average person’s microbiome, and that these differences may contribute to the development or worsening of people’s diabetes. That’s led to speculation that FMT—which is intended to replace a person’s gut microbiome with that of a donor’s—could be used to tamp down people’s symptoms associated with their diabetes, particularly gastrointestinal ones.
For their trial, the researchers recruited 20 people living with type 1 diabetes who had moderate to severe gastrointestinal problems. Half the volunteers were randomized to be initially given a course of 25 pills containing donor feces, while the rest were given placebos (in a second, later round of treatment, all of the patients were given FMT).
The patients who first took FMT experienced a larger reduction in gastrointestinal symptoms than those who first took placebo, the researchers found. One measure included in the study was the Patient Assessment of Gastrointestinal Symptom Severity Index, which is scored from 0 to 100. People in the FMT group saw their median score of this measure drop from 42 to 25, whereas those in the placebo group saw the median score drop from 47 to 41. The researchers also detected noticeable changes in people’s microbiomes following FMT. And importantly, there was no significant difference in the adverse events reported from each group—an indication of FMT’s overall safety. Those originally in the placebo group also experienced symptom improvement once they were switched to FMT as well.
“Our findings suggest that FMT may represent a potential new therapeutic option that could fundamentally transform the current approach to treating bowel symptoms in patients with type 1 diabetes,” the researchers wrote in their paper, published earlier this month in the journal eClinicalMedicine.
The findings are based on a small sample size, so it will take additional, larger studies to confirm FMT’s viability for people with these symptoms, which isn’t a sure-fire thing. Currently, FMT is known to reliably help treat recurrent gut infections caused by the bacteria Clostridioides difficile. But studies testing FMT for other gut-related health problems have provided mixed results to date. Still, the researchers are hopeful about the therapy’s potential for people with type 1 and possibly even type 2 diabetes.
“To our knowledge, this study represents the most promising clinical effect of FMT beyond its established efficacy in treating [Clostridioides difficile] infection,” they wrote. “In this regard, FMT holds promise as an easy-to-perform, well-tolerated, and efficient treatment for a group of patients with very severe symptoms.”