What question did this study set out to answer?

Investigate how multi-strain probiotics affect metformin tolerance and gut microbiome in type 2 diabetes.

April 18, 2026Biomedicine & Pharmacotherapy0 citationsOpen Access

Multi-strain probiotic enhances metformin tolerance by modulating gut microbiome and bile acid pathways: Insight from multi-omics post-hoc analysis (ProGasMet trial)

HKHanna KwiendaczMedical University of Silesia DCDanuta Cembrowska-LechUniversity of Szczecin KSKarolina Skonieczna-Żydecka

Puntos clave

Investigate how multi-strain probiotics affect metformin tolerance and gut microbiome in type 2 diabetes.
Post-hoc analysis from the ProGasMet trial
Assessment of microbiome and metabolome changes
Bile acid profiling and quantification
Probiotic use leads to significant shifts in gut microbiome composition
Hyodeoxycholic acid levels show notable changes correlating with improved metformin tolerance
Suggests the importance of secondary bile acid pathways in enhancing drug tolerance

Resumen

Probiotic supplementation may be associated with coordinated microbiome-metabolome shifts in metformin-intolerant type 2 diabetes, highlighting bile acid remodelling, particularly hyodeoxycholic acid, as a plausible candidate for improved tolerability. These results support prioritising secondary bile acid-microbiome pathways for confirmation in larger trials incorporating targeted bile acid quantification and causal modelling.

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