Dietary Changes and Gut Dysbiosis in Children With Type 1 Diabetes

ABSTRACT

Objective: Gut dysbiosis in type 1 diabetes (T1D), characterized by high Bacteroides proportion, tends to reverse as T1D progresses, without reaching full recovery. Since diet influences microbiota structure, the aim was to evaluate the impact of dietary changes on Bacteroides proportion the first year of T1D evolution.

Methods: Dietary intake was assessed by 24-hour recalls and Bacteroides proportion by quantitative polymerase chain reaction, in 10 Mexican children (11.6 ± 1.92 years) with T1D at baseline and 3, 6 and 9 months' follow-up. Repeated measures analysis of variance and multiple linear regression were performed to compare ingested nutrients in relation with Bacteroides proportion. Effects over time were evaluated by mixed regression models.

Results: Patients with T1D decreased their energy (2621.89 to 1867.85 kcal, p = 0.028), protein (83.06 to 75.17 g, p = 0.012), and saturated fat consumption (40.83 to 25.23 g, p = 0.031) from baseline to 3 months, without posterior changes. Bacteroides proportion increased in the first months and tended to decrease at around 9 months (p > 0.05) and was positively correlated with saturated fat (β = 3.70, p = 0.009) and total carbohydrates (β = 0.73, p = 0.005) at 3 months. Carbohydrate consumption was related to decreased Bacteroides abundance over time (β = −14.9, p = 0.004), after adjusting for glycosylated hemoglobin.

Conclusions: Besides autoimmunity, diet appears to have a central role determining the T1D-associated dysbiosis evolution.

KEYWORDS:

• Diet
• gut dysbiosis
• type 1 diabetes
• Mexico

Acknowledgments

LLD and SVAP thank CONACYT for their scholarships to complete their master's and doctoral studies. All authors are grateful to Maribel Valencia from CIAD for her technical assistance and to Dr. Gabriela Garcia and Dr. Cynthia Bueno from the Instituto Mexicano del Seguro Social and Hospital Infantil del Estado de Sonora for the diagnosis and treatment of T1D children, and for providing the hospital facilities for the recruitment of their patients.

Author contributions

MEML and AMC designed the study and wrote the manuscript. LLD recruited and followed patients with type 1 diabetes and conducted the dietary evaluation and analysis. SVAP contributed with haplotype typing and microbiota quantification, and GCJ carried out the statistical analysis and helped with manuscript editing. AMC coordinated the project. All authors read and approved the final version of the manuscript.

Conflicts of interest

The authors declare no conflict of interest.