Fecal transplant success for diabetes might depend on the recipient's gut microbes

A small clinical trial in the Netherlands found that a fecal transplant from a lean donor can temporarily improve insulin resistance in obese men -- but only half of the recipients responded. Upon further investigation, the researchers discovered that they could predict the success of the treatment by analyzing each patient's fecal gut-bacterial makeup. This understanding could help shape the development of personalized fecal transplant for diabetes. The work appears October 3 in the journal Cell Metabolism.

"We have now shown that you can categorize people based on their fecal samples," says senior author Max Nieuwdorp of the Department of Internal and Vascular Medicine at the University of Amsterdam. "This allows us to classify diseases with more sensitivity."

Six weeks after participants received fecal material from a lean donor, half of them saw an improvement in insulin sensitivity, whereas the other half saw no change. "The fifty-fifty responder-to-non-responder rate surprised me," says Nieuwdorp. "I thought we would have fewer people respond to the transplant." The researchers then compared the pre-treatment microbiota of both groups and found that the non-responders were the ones who started off with less bacterial diversity.

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