Impaired glucose metabolism in irritable bowel syndrome: personalised low-glycaemic diet as potential therapeutic target

Abstract

We read with great interest the recent study by Gilliam-Vigh et al demonstrating significant transcriptomic alterations in the intestinal mucosa of individuals with type 2 diabetes (T2D), particularly increased immune activation, altered barrier function in the large intestine and metabolic dysfunction.1 These findings provide crucial mechanistic insights that complement observations on metabolic disturbances in patients with irritable bowel syndrome (IBS), supporting the rationale for glucose-targeted interventions. Given the substantial interindividual variability in glycaemic responses,2 we investigated the therapeutic potential of a personalised low-glycaemic diet (PLGD) in IBS management. In our nutritional observation study of 20 age and gender-matched patients with IBS, we compared clinical outcomes between those receiving either a PLGD or the established low-FODMAP diet (LFD) over a minimum 3-month period (figure 1). Figure 1 Precomparison and postcomparison in IBS Severity Scoring System (IBS-SSS) between age- and gender-matched patients with IBS receiving either a personalised low-glycaemic diet (PLGD, n=10) or a standard therapy low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet (LFD, n=10) using paired Wilcoxon test. The group means are represented by a dashed line, and an arrow represents the reduction in IBS-SSS, with a reduction between 50 and 230 points in PLGD and between 30 and 290 points in LFD. *P<0.05. Remarkably, our personalised nutrition (PN) approach achieved symptom improvement comparable to standard LFD, assessed …