Fecal transplants offer new possibilities for treating diabetic gastroenteropathy.

The results of the study have been published in the journal eClinicalMedicine.

Diabetic gastroenteropathy affects up to a quarter of all patients with type 1 diabetes, often leading to debilitating symptoms such as nausea, vomiting, bloating, and diarrhea. These symptoms arise from nerve damage affecting bowel motility and the composition of gut microbiota. Despite the severity of the issue, treatment options remain limited.

“After FMT, patients experienced a significant improvement in quality of life and symptoms, far exceeding what we observed with placebo. For the first time, FMT was tested in this patient group using a placebo control. The results look very promising,” says Katrine Lundby Høyer, the lead author of the study, a PhD student at the Department of Clinical Medicine at Aarhus University, and a physician at the Department of Hepatology and Gastroenterology at Aarhus University Hospital.

The study involved 20 patients who were randomly assigned to receive either a single dose of capsules containing donor feces or a placebo. After four weeks, all participants received donor feces. The results showed the following:

• Significant reduction in symptoms: Patients receiving FMT experienced a substantial reduction in symptoms on the Gastrointestinal Symptom Rating Scale (GSRS-IBS)—the score decreased from 58 to 35. In the placebo group, the scores only dropped from 64 to 56.
• Improvement in quality of life: Quality of life in the FMT group improved on the Irritable Bowel Syndrome Impact Scale (IBS-IS) from 108 to 140 points, while in the placebo group, it increased from 77 to 92 points.
• Mild side effects: Side effects were mild and short-lived, including diarrhea, bloating, and abdominal pain, with no serious adverse effects reported.

FMT is already known as an effective treatment method for Clostridioides difficile infections, but this is the first time it has been tested in patients with diabetic gastroenteropathy. The study demonstrated that the treatment is safe and effective, providing hope for a group of patients with few other options.

“For some patients, this treatment means regaining control over their daily lives. The method has great potential, and we hope to replicate the study on a larger scale to help more patients,” says Høyer.

The results represent an important step forward in the treatment of diabetic gastroenteropathy. However, the researchers emphasize that further studies are necessary to identify long-term effects and determine which patients will benefit the most from the treatment.

“Now we need to explore how to implement this treatment method on a broader scale and ensure its availability for patients with the greatest needs,” shares Klaus Krogh, professor and chief physician at the Department of Hepatology and Gastroenterology.