Endocrine Abstracts

Aim

To assess the effect of Zakofalk in complex therapy in patients with type 2 diabetes and obesity.

Materials and methods

We examined 68 patients with type 2 diabetes and 28 with obesity (body mass index over 30 kg/m²). The control group consisted of 20 people. The groups were comparable in terms of age, sex, and antihyperglycemic therapy. In addition to a thorough clinical examination of all study participants, the content of short-chain fatty acids (SCFA)took place. SCFA before and after four weeks of Zakofalk therapy. In 45 patients with type 2 diabetes during examination, including capsule endoscopy, endoscopic and histological changes in the lining of the colon were diagnosed, their own previously not diagnosed microischemic colitis. Some patients with type 2 diabetes and obesity have a concomitant disease with irritable bowel syndrome. The results of the study of the SCFA content are presented below. According to the structure of aspen bacterial metabolites of the colon in the study groups, P < 0.05: Butyrate: type 2 diabetes + NAFLD at 19%, the norm at 16% Propionate: type 2 diabetes + NAFLD at 23%, the norm at 20% Acetate: Type 2 DM + NAFLD at 58%, normal at 64% The total concentration of SCFA in patients with type 2 diabetes, P < 0.02: Obesity group: 11.4 ± 4.1 mg/g Type 2 diabetes group: 4.9 ± 1.0 mg/g Norm: 10.6 ± 3.1 mg/g

Conclusions

Thus, the appointment of butyrate seems to be a promising approach to improve the effectiveness of treatment of patients with type 2 diabetes and obesity. The use of butyrate (Zakofalk) in complex therapy leads to a decrease in systemic and local inflammation, regulation of the production of glucagon-like peptide-1 and glucagon-like peptide-2, PYY, reprofiling of the microbiota from lactate to butyrate, a decrease in insulin resistance, an improvement in the glycemic profile, restoration of the visceral barrier intestine, stimulation of its own butyrate-producing microbiota. In the treatment of microischemic colitis, the drug helps to reduce flatulence, abdominal pain, normalize stool, and modify eating behavior.