SpartanDO Expert Take 2021-11

November 2021

Gut health, diabetes and preventing bone loss

In recognition of National Diabetes Month in November, this Expert Take blog post focuses on research that optimizes microbiome health to treat bone loss from diabetes.


Looking for a new diabetic-friendly food? Try kimchi—or better yet, a probiotic.

Dr. Laura McCabe, MSU Foundation Professor and researcher at the Department of Physiology, explains how her decades-long research focuses on innovative approaches to treating diabetes and preventing bone loss through targeted microbiome strategies.

“Our lab was the first to show that in addition to Type 1 diabetes causing bone loss, it also increases marrow fat inside bones” she says.

That’s concerning for the over 34 million Americans —  10.5% of the US population — who have diabetes.

After looking at linkages between gut inflammation and bone loss, McCabe switched to researching how to prevent bone loss by reducing inflammation in the gut.

She collaborated with a colleague at MSU to prove that treating Type 1 diabetes with a probiotic reduces gut inflammation and prevents bone loss.

Optimizing microbiome health to influence systems biology

“What I think is the coolest about all of this is that we used to think that if you want to treat something, you use the drug to treat the thing — the bone in this instance — but now we have a way that we can target the gut to help the bone,” McCabe says excitedly. “We’re using systems biology to communicate between systems to get one part of the body [the gut] to communicate with another body part [osteoblasts in the bone]! It’s so unlike how we usually think about things since we usually go direct.”  

She continues to explain that the gut acts as the sensor for the environment. When it detects inflammation caused by a bad diet, the gut signals that it needs help addressing the inflammation, resulting in other systems pausing their functioning, such as building healthy bone and bone marrow.

An added benefit of using probiotics as a targeted therapeutic is that it is a natural approach with minimal complications, and adds another tool to an osteopathic physician’s toolkit to treat a patient more holistically before (or in tandem with) medications.

Looking for a new diabetic-friendly food? Try kimchi—or better yet, a probiotic.“You have to take medication to maintain blood glucose to reduce complications [of diabetes], but we can also think about natural ways to support that health—things like exercise, healthy diet, fiber, probiotics,” McCabe reflects.

“We haven’t even uncovered all the foods that support healthy bacteria like the Lactobacillus reuteri (L.reuteri) strain of probiotic bacteria used in the studies. Certainly, prebiotic- and probiotic-containing foods like kefir, yogurt, milk, and fermented foods like kimchi and sauerkraut, can be added to your diet to help your gut and bone health. People might be more willing to try things that are natural. And if you can’t totally change your diet, then you might be able to more easily add a probiotic supplement,” McCabe says.

Patents and other research

Recently, with the help of the MSU Innovation Center, BioGaia — a Swedish health care company — McCabe, and Robert Britton, former associate professor in MSU’s Department of Microbiology and Molecular Genetics, patented the use of a probiotic as a preventative measure against the development of osteoporosis. BioGaia sells the probiotic as part of its lineup of dietary supplements, and it’s now purchased by people around the world.

With several groundbreaking discoveries and a patent under her belt, McCabe, who began teaching and researching at MSU in 1996, is expanding her research focus to next look at a prebiotic to stimulate the growth of good bacteria. The fiber in the prebiotic would feed the probiotic to keep your gut healthy. “If your gut is healthy, your bones and other organs will be healthy, too,” she adds.

And that’s not all. McCabe’s lab has also conducted studies with high-fat diets and the induction of Type 2 diabetes to better understand how exercise can change the gut’s microbial composition. Her research has shown that the microbiota changes in mice on a high-fat diet, but that exercise can help regulate those changes and bring the levels back closer to normal — or in other words, exercise helps prevent bone loss, too.

Through all of these exciting discoveries, McCabe has mentored several SpartanDO students in her lab, including Sandy Raehtz (DO-PhD ’16), Nick Chargo (DO-PhD), and Claire Spivey (OMS-I), who have studied estrogen and diabetes, prebiotics, and the gut barrier, respectively. McCabe also works with SpartanDO students who complete rotations in her lab, and throughout the year in her role as the advisor of the American Physician Scientists Association (APSA) student club.