Multi-omics signatures in new-onset diabetes predict metabolic response to dietary inulin: findings from an observational study followed by an interventional trial
Journal article, 2023

AIM: The metabolic performance of the gut microbiota contributes to the onset of type 2 diabetes. However, targeted dietary interventions are limited by the highly variable inter-individual response. We hypothesized (1) that the composition of the complex gut microbiome and metabolome (MIME) differ across metabolic spectra (lean-obese-diabetes); (2) that specific MIME patterns could explain the differential responses to dietary inulin; and (3) that the response can be predicted based on baseline MIME signature and clinical characteristics. METHOD: Forty-nine patients with newly diagnosed pre/diabetes (DM), 66 metabolically healthy overweight/obese (OB), and 32 healthy lean (LH) volunteers were compared in a cross-sectional case-control study integrating clinical variables, dietary intake, gut microbiome, and fecal/serum metabolomes (16 S rRNA sequencing, metabolomics profiling). Subsequently, 27 DM were recruited for a predictive study: 3 months of dietary inulin (10 g/day) intervention. RESULTS: MIME composition was different between groups. While the DM and LH groups represented opposite poles of the abundance spectrum, OB was closer to DM. Inulin supplementation was associated with an overall improvement in glycemic indices, though the response was very variable, with a shift in microbiome composition toward a more favorable profile and increased serum butyric and propionic acid concentrations. The improved glycemic outcomes of inulin treatment were dependent on better baseline glycemic status and variables related to the gut microbiota, including the abundance of certain bacterial taxa (i.e., Blautia, Eubacterium halii group, Lachnoclostridium, Ruminiclostridium, Dialister, or Phascolarctobacterium), serum concentrations of branched-chain amino acid derivatives and asparagine, and fecal concentrations of indole and several other volatile organic compounds. CONCLUSION: We demonstrated that obesity is a stronger determinant of different MIME patterns than impaired glucose metabolism. The large inter-individual variability in the metabolic effects of dietary inulin was explained by differences in baseline glycemic status and MIME signatures. These could be further validated to personalize nutritional interventions in patients with newly diagnosed diabetes.


Nikola Daskova

Institute of Clinical and Experimental Medicine

Charles University

I. Modos

Institute of Clinical and Experimental Medicine

M. Krbcová

Kralovske Vinohrady University Hospital

M. Kuzma

Chinese Academy of Sciences

Helena Pelantova

Chinese Academy of Sciences

J. Hradecký

Czech University of Life Sciences Prague (CULS)

Marie Heczkova

Institute of Clinical and Experimental Medicine

Miriam Bratova

Institute of Clinical and Experimental Medicine

Petra Videnska

Mendelova univerzita v Brne

Petra Splichalova

Masaryk University

M. Králová


Institute of Clinical and Experimental Medicine

Marina Henikova

Kralovske Vinohrady University Hospital

J. Potočková

Kralovske Vinohrady University Hospital

A. Ouřadová

Kralovske Vinohrady University Hospital

Rikard Landberg

Chalmers, Life Sciences, Food and Nutrition Science

T. Kühn

University Hospital Heidelberg

Queen's University Belfast

Monika Cahova

Institute of Clinical and Experimental Medicine

Jan Gojda

Kralovske Vinohrady University Hospital

Nutrition and Diabetes

2044-4052 (eISSN)

Vol. 13 1 7-

Subject Categories

Endocrinology and Diabetes

Nutrition and Dietetics





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Latest update

5/8/2023 1