Metformin-supportive nutrition: When gut microbes eat drugs.

Microbial AdhE is identified as a metformin-degrading enzyme in metformin low-responders, explaining variability in treatment efficacy for type 2 diabetes.

• Why it matters: Metformin is first-line for type 2 diabetes in adults and children, yet patient responses vary widely, leaving a gap in understanding why some benefit less.
• What they did: Zhao et al. pinpointed microbial AdhE in metformin low-responders and proposed an enzyme-based microbiome intervention to counter metformin degradation.
• The result: The findings suggest that targeting AdhE activity via microbiome intervention may rescue metformin therapy in patients who otherwise respond poorly.

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