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A-Mansia’s approach : The first effective and natural dietary supplement containing pasteurized Akkermansia muciniphila to tackle diabesity”

Diabesity: obesity and diabetes

The number of overweight individuals is fast increasing worldwide, and this increase has meant a concomitant rise in the prevalence of type 2 diabetes. With type 2 diabetes reaching epidemic proportions, the International Diabetes Federation (IDF) has predicted that the number of individuals with type 2 diabetes may rise to almost 333 million by 20251. For this reason, the World Health Organization (WHO) has called obesity and diabetes the “21st century epidemic”. The exact relationship between elevated fasting blood sugar and overweight remains somewhat of a “chicken or the egg” controversy. Insulin resistance is pre-requisite for the appearance of other MetS indications (i.e., overweight, dyslipidaemia, and hypertension). While some studies support this view, other evidence suggests that central (abdominal fat) overweight triggers systemic (whole-body) insulin resistance. Regardless of the precise cause-and-effect relationship, the term “diabesity” has been coined by Francine Kaufman in 2005 to emphasize the close relationship between these two diseases. Indeed, overweight and type 2 diabetes frequently occur together, and the vast majority of type 2 diabetic individuals are or have been overweight. Along with genetic susceptibility, overweight are the most important risks factor for type 2 diabetes. The term “diabesity” singles out excess body weight as the major cause of type 2 diabetes2,3


Let us begin with definitions for overweight and obesity. These are both defined as abnormal or excessive fat accumulation that may impair health. A common indicator used to estimate them is the Body Mass Index (BMI). It is based on the weight and the height of an individual: BMI = mass (kg) / height (m²). In short, a person with a BMI greater than or equal to 25 is considered overweight and above or equal to 30 is considered obese.

The worldwide prevalence of obesity nearly tripled between 1975 and 2016. In other words, in 2016, more than 1.9 billion adults (39% of the adult global population) were overweight (BMI ≥ 25). Of these, over 600 million were obese (BMI > 30). In Europe, more than half the population is overweight (BMI > 25) and up to 30% is obese (BMI  30)4.

2100100 body mass index graph

Prediabetes and diabetes

In addition to obesity, the prevalence of prediabetes is increasing and becoming a major public health issue. Prediabetes is defined as an intermediate state of hyperglycaemia in which glucose levels rise above the normal state but are below the diagnostic levels of diabetes. There are no symptoms clearly associated with prediabetes. It is a condition that can remain silent and unidentified for many years, laying the basis for severe complications. A simple blood sample analysis can easily identify people at risk. Many scholarly organisations in North America define prediabetes as impaired fasting glycaemia. It is characterized by a fasting blood sugar level (HbA1C level) ranging between 100 to 125 mg/dL (5.7% – 6.5% mmol/L).

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Prediabetes will progress to overt type-2 diabetes in approximately 5-10% of subjects annually. According to American Diabetes Association expert panel 70% of individuals with prediabetes will develop overt diabetes within their lifetime5. But prediabetes may also convert back to normoglycaemia thanks to lifestyle modifications. That is why it is of upmost importance to detect people suffering from prediabetes:
  • in order to put in place some key interventions to get back to normal glycaemia;
  • and prevent the risk of developing type-2 diabetes.

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.

Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. The majority of people with diabetes have type 2 diabetes. This type of diabetes is largely the result of excess body weight and lack of physical activity.

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Impact of the gut microbiota in the development of obesity and prediabetes

The western and modern lifestyle is characterized by a poor-quality diet (high fat and low fibre content), sedentary habits, drug use, etc. All of these characteristics can lead to gut microbiota dysbiosis. This dysbiosis promotes diet-induced obesity and metabolic complications through a variety of mechanisms, including:

  • immune dysregulation
  • altered energy regulation, and
  • pro-inflammatory mechanisms.

Indeed, during obesity, the composition and function of the gut microbiota is altered. Consequently, the functions of the gut microbiota are impacted, especially the gate-keeper functions of the gut barrier.

A consequence of the alteration of the gut barrier’s keeper function is an increased permeability in the gut. This process is sometimes called “leaky gut”. This increased gut permeability allows the passage from the intestinal lumen to the bloodstream of compounds coming from a person’s diet or from the gut bacteria. Some of these compounds are toxins, such as lipopolysaccharides (LPS). These toxins are pro-inflammatory. They activate the immune system and induce chronic low-grade inflammation, namely a low-level inflammation but which lasts a long time (several years). To explain further, this chronic low-grade inflammation can induce metabolic disorders such as insulin resistance. This happens due to a decrease of the insulin’s action on its receptor. Eventually, insulin resistance can lead to the development of type-2 diabetes. Furthermore, chronic low-grade inflammation is also associated with the development of atherosclerosis, cancers and neurodegenerative diseases.  

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How to tackle diabesity?

Target a common thread: gut barrier dysfunction and stop the vicious circle of chronic low-grade inflammation with the supplementation of A. muciniphila. There is urgent need for prevention at the early stages of disease progression—i.e. when excess weight (specifically, abdominal fat) and fasting blood glucose are elevated, but not yet critical.

“The A-Mansia approach to solving the “Diabesity” epidemic is to design innovative health solutions based on Akkermansia muciniphila tackeling the causes and the consequences of excess weight and prediabetes.”

  1. Whiting, D.R., Guariguata, L., Weil, C. & Shaw, J. 2011 IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 94, 311-321.
  2. Shafrir, E. 1996 Development and consequences of insulin resistance: lessons from animals with hyperinsulinaemia. Diabetes Metab22, 122-131.
  3. Astrup, A. & Finer, N. 2000 Redefining type 2 diabetes: ‘diabesity’ or ‘obesity dependent diabetes mellitus’? Obes Rev 1, 57-59.
  4. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  5. https://www.diabetes.org