This chapter discusses a study that demonstrates how the microbiome is central to blood sugar regulation. The study involved a group of people with type two diabetes who were randomized to either a standard diabetic diet or a high fiber, high prebiotic diet. The high fiber diet led to a shift in their microbiome towards the microbes that produce butyrate, a short chain fatty acid. They also had higher levels of butyrate in their stool and increased GLP1 levels. After 28 days, those on the high fiber diet had significantly lower hemoglobin A1c levels and continued to show improvements over time. The diets were calorie-matched and had the same macros, indicating that the difference was due to fiber intake. Fecal transplants from before and after the high fiber diet were given to mice, and the mice that received the transplant after the high fiber diet had better blood sugar regulation.

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