Pregnant women with type 1 diabetes likely to have gut inflammation

Women with type 1 diabetes (T1D) present with a shift in the gut mycobiome across pregnancy, and this shift is strongly linked to gut inflammation and impaired intestinal barrier function, as reported in a study.

Researchers collected faecal samples (n=162) from 70 pregnant women, among whom 45 had T1D, across all trimesters. The samples were tested for the presence fungi using internal transcribed spacer 1 amplicon sequencing. Markers of intestinal inflammation (faecal calprotectin) and intestinal epithelial integrity (serum intestinal fatty acid binding protein [I-FABP]), and serum antibodies to Saccharomyces cerevisiae (ASCA) were also measured.

Overall, a total of 234 fungal operational taxonomic units (OTUs) were identified. The corresponding ranges per sample in the T1D vs control groups were 2–9 vs 2–8 in the first trimester, 1–12 vs 1–9 in the second trimester, and 1–14 vs 2–11 in the third trimester.

Most of fungal OTUs were specific to each individual, with the samples generally dominated by the phylum Ascomycota, representing ∼50 percent of the total OTUs. S. cerevisiae was detected in 71.8 percent of women in the T1D group and 64.4 percent in the control group, at an average abundance of 42.3 percent and 34.9 percent, respectively. Candida albicans species, in the phylum Ascomycota, was present in 10.8 percent of women in the T1D group and 7.2 percent in the control group, at an average abundance of 56 percent and 30 percent, respectively.

The results indicated that T1D group had decreased fungal alpha diversity by the third trimester, which seemed to be related with an increased abundance of S. cerevisiae that was inversely associated to the abundance of the anti-inflammatory butyrate-producing bacterium Faecalibacterium prausnitzii.

Furthermore, women with T1D had higher levels of calprotectin, I-FABP, and ASCA.

Whether or not the altered gut mycobiome in T1D may contribute to a higher rate of pregnancy complications requires further study.