Gut Microbiome Activity Contributes to Prediction of Individual Variation in Glycemic Response in Adults.

Blood sugar dysregulation is caused by various underlying conditions, including type 2 diabetes, and this may lead to extended periods of hypoglycemia or hyperglycemia, which can be harmful or deadly. Clinically, glycemic control is a primary therapeutic target for dysglycemia, and food and nutrition are frequent interventions used to reduce postprandial blood glucose excursions. Primary determinants of postprandial glycemic response (PPGR) include dietary carbohydrates, individual phenotypes, and individual molecular characteristics which include the gut microbiome. Typical investigations of gut microbiomes depend on analysis methods which have poor taxonomic resolution, cannot identify certain microorganisms, and are prone to errors. In this study, each RNA molecule was identified and counted, allowing quantitative strain-level taxonomic classification and molecular pathway analysis. The primary goal of the study was to assess the impact of microbial functional activity on PPGR. The study was conducted in the USA and involved a multiethnic population of healthy adults with HbA1c levels below 6.5. All participants received 14-day omnivore diets or vegetarian/gluten-free diets, depending on nutritional requirements (omnivore diets include meat while vegetarian/gluten-free diets exclude both gluten and meat). Over this timeframe, blood glucose levels were measured in 15-min intervals, 24 h per day, capturing postprandial responses for more than 27,000 meals, including more than 18,000 provided meals which spanned a wide range of foods and macronutrient characteristics. Computational modeling demonstrated the statistical significance of all features and identified new features which may be relevant to glycemic control. These results show, for the first time, that a person's glycemic response depends on individual traits, including both their anthropometrics and their gut metatranscriptome, representing the activity of gut microbiomes.