Metformin intolerance in type 2 diabetes mellitus – the possibility of using a multi-strain probiotic

Abstract

Metformin is a widely used drug in the management of type 2 diabetes (T2DM); however, its administration is linked with the elevated incidence of gastrointestinal (GI) adverse events (AEs) limiting its use or treatment intensification. The complex interplay between metformin and the gut ecosystem has emerged as a additional of interest, particularly the drug’s impact on the composition and function of the gut microbiota. Therefore, in this review we present the possibility of interfering with microbiota by using multi-strain probiotic to mitigate the GI AEs in patients with metformin intolerance. We synthesise findings from various research studies that explore the modification of gut microbiota as a means to reduce GI AEs in T2DM patients with metformin intolerance. As we discuss the available evidence, the narrative outlines the mechanisms through which probiotics may exert beneficial effects and evaluate the efficacy of different probiotic formulations. The results of research on gut microbiota modification in patients with T2DM and metformin intolerance appear promising in alleviating GI AEs.