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

Hanna Kwiendacz; Danuta Cembrowska-Lech; Karolina Skonieczna-Żydecka; Karolina Klimontowicz; Konrad Podsiadło; Anna Wierzbicka-Woś; Daniel Styburski; Mariusz Kaczmarczyk; Janusz Gumprecht; Igor Łoniewski; Katarzyna Nabrdalik

doi:10.1016/j.biopha.2026.119370

April 14, 2026Biomedicine & PharmacotherapyOpen Access

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

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Key Points

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

Implication

Multi-strain probiotics improve metformin tolerance in type 2 diabetes, suggesting microbiome-bile acid pathways may play a key role.

Abstract

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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Cite This Study

Kwiendacz et al. (2026) studied this question.

synapsesocial.com/papers/69e31ec840886becb653e6b6 https://doi.org/10.1016/j.biopha.2026.119370

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

Key Points

Implication

Abstract

Discussion

Cite This Study

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

Key Points

Implication

Abstract

Discussion

Cite This Study

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