Research from the United States has suggested that diabetes problems based around an inability to manage blood sugar levels could begin in the intestines, rather than in the pancreas, which produces insulin, or the liver, where the body stores sugar, as previously believed.
The study, by a team from Washington University School of Medicine in St. Louis and which was published in the journal Cell Host and Microbe, carried out experiments on mice lacking the enzyme fatty acid synthase (FAS) in their intestine, harmful bacteria that can attack the colon and small intestine, producing the inflammation underpinning both insulin resistance and diabetes.
FAS is normally important in the production of lipids, and is regulated by insulin, but diabetes patients have defects in their FAS. The mice were shown to develop chronic inflammation in the gut, often a predictor for the onset of diabetes. Inflammation can result in insulin resistance and prevent the production of insulin, interfering with the control of blood sugar. Insulin resistance can also promote inflammation.
Lead researcher Clay F. Semenkovich said “Diabetes may indeed start in your gut. When people become resistant to insulin, as happens when they gain weight, FAS doesn’t work properly, which causes inflammation that, in turn, can lead to diabetes.”
First author Xiaochao Wei also commented “Fatty acid synthase is required to keep that mucosal layer intact. Without it, bad bacteria invade cells in the colon and the small intestine, creating inflammation, and that, in turn, contributes to insulin resistance and diabetes.”

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