Effects of nutritional therapy on gastrointestinal microbial digestion and barrier defense markers in elderly patients with diabetes

Objective We sought to investigate the effects of gastrointestinal nutrition therapy on gastrointestinal microbial digestion and barrier defense markers in elderly patients with diabetes. Methods A total of 120 elderly patients with type 2 diabetes were enrolled at our hospital between January 2020 and December 2022. The participants in this study were randomly allocated into either the nutritional group ( n  = 60) who underwent gastrointestinal nutrition therapy or the control group ( n  = 60) who underwent conventional T2DM diet management for a period of 12 weeks. Clinical data, as well as small intestinal permeability measured by the lactulose-mannitol urine test, plasma circulating IL-6 and zonulin levels measured by ELISA, and expressions of ZO-1 and Claudin-3 in blood analyzed through Western blotting were collected. Results The nutrition group demonstrated a higher proportion of patients achieving HbA1c < 7% compared to the control group ( P  < 0.05). Moreover, the nutrition group exhibited a greater reduction in fasting and postprandial blood glucose levels compared to the control group ( P  < 0.05). The concentrations of formate-tetrahydrofolate ligase and acetic CoA transferase were significantly increased in the nutrition group compared to the control group ( P  < 0.05). Fecal analysis revealed higher levels of acetic acid and butyric acid in the nutrition group compared to the control group ( P  < 0.05). The ratio of lactulose to mannitol was higher in the nutrition group compared to the control group ( P  < 0.05). Furthermore, the nutrition group showed lower levels of IL-6 and zonulin compared to the control group ( P  < 0.05). Conclusion Personalized gastrointestinal nutrition therapy was found to enhance the production of short-chain fatty acids and preserve intestinal permeability, leading to improved gastrointestinal microbial digestion and barrier defense in elderly patients with diabetes.