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Drug metabolism

Gut bacteria thwart the blood sugar-lowering effect of acarbose

Nature Metabolism volume 5, pages 732–734 (2023)Cite this article

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In this issue of Nature Metabolism, a gut bacterial glucosidase that degrades the antidiabetic drug acarbose is linked to poor treatment response. Its widespread distribution in the human microbiome could compromise the efficacy of acarbose treatment in many patients.

Oral antidiabetics have been used as effective tools in the treatment of diabetes for several decades. However, many issues remain to be addressed, such as interpersonal differences in treatment response or the range of side effects that patients experience1. Over the past decade, we have come to realize that the answer to these open questions can be found, at least in part, in the individual composition of the patient’s microbiome. We have learnt that several classes of antidiabetic drugs, including metformin and incretin-based therapies, alter the composition and function of the gut microbiome, which, in turn, can influence glucose metabolism and insulin sensitivity2.

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Fig. 1: Unraveling the mechanism of Apg-mediated reduction in the efficacy of acarbose treatment.

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Authors and Affiliations

  1. Interfaculty Institute of Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany

    Melanie M. Brauny & Lisa Maier

  2. Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infections, University of Tübingen, Tübingen, Germany

    Melanie M. Brauny & Lisa Maier

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  1. Melanie M. Brauny
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  2. Lisa Maier
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Correspondence to Lisa Maier.

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The authors declare no competing interests.

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Brauny, M.M., Maier, L. Gut bacteria thwart the blood sugar-lowering effect of acarbose. Nat Metab 5, 732–734 (2023). https://doi.org/10.1038/s42255-023-00798-8

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  • DOI: https://doi.org/10.1038/s42255-023-00798-8

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