Research Summary

Analyzed using Evidence Intelligence™

Metformin and Liraglutide Improve Gut Microbiome in Youth with Diabetes

Key finding

Met was associated with greater relative abundance of Eubacterium (p < 0.05).

This study examined the effects of Metformin and Liraglutide on the gut microbiome in youth with type 2 diabetes, revealing significant changes in microbial abundance and metabolic markers.

Evidence strength

Moderate confidence

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Some Concerns bias

Last updated July 4, 2026

Quick read

Study at a glance

The essential study design details in one scan.

Population

Young Adult (19–39), Middle Aged (40-64), Male, Female, Asia-Pacific (APAC), with T2 Diabetes

Intervention

Metformin, Metformin + Liraglutide

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Primary outcome

Relative abundance of Eubacterium

Evidence

Moderate confidence

Plain-language summary

What this paper says

A plain-language read of the study's main message and where it applies.

Study focus

This study examined the effects of Metformin and Liraglutide on the gut microbiome in youth with type 2 diabetes, revealing significant changes in microbial abundance and metabolic markers.

Clinical relevance

Understanding how diabetes treatments like Metformin and Liraglutide affect gut microbiome composition can help healthcare providers tailor interventions for youth with type 2 diabetes. The changes in gut bacteria and metabolic markers could lead to improved management of the disease and better health outcomes for this population.

Keep in mind

The study's sample size may limit the generalizability of the findings. The long-term effects of these treatments on gut microbiome and metabolic health remain unclear. Potential confounding factors were not fully controlled for in the analysis.

Published in

Journal Reference

Publication details and source links for this paper.

Sophia BG, Sidharth PM, Shalini J, et al. Metformin and Liraglutide Treatment Effects on Gut Microbiome in Youth-Onset Type 2 Diabetes. Gut Microbes. 2025;17(1):2558071. doi:10.1080/19490976.2025.2558071

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Main Effects

Metformin was associated with a greater relative abundance of Eubacterium (5.72% increase, p < 0.05).

Metformin increased plasma cholic secondary bile acids by more than 1.5-fold (p ≤ 0.002).

The combination treatment (Met+Lira) increased Bacteroides fragilis (p < 0.05) but decreased Streptococcus thermophilus (p < 0.05).

Evidence network

How this study fits

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Evidence Context

This study contributes evidence to Metformin, Metformin + Liraglutide and Fasting Plasma Glucose (FPG), Plasma cholic secondary bile acids, Relative abundance of Bacteroides ovatus, and 4 more.

This study contributes evidence to

Intervention

Metformin

Outcome

Fasting Plasma Glucose (FPG)

Evidence topic

Glycemic Control

Primary intervention

Metformin

Primary outcomes

Fasting Plasma Glucose (FPG)
Plasma cholic secondary bile acids
Relative abundance of Bacteroides ovatus

Evidence topics

Glycemic Control Metformin Liraglutide

Primary intervention

Metformin

Primary outcomes

Fasting Plasma Glucose (FPG)Plasma cholic secondary bile acids Relative abundance of Bacteroides ovatus

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

Evidence pairs

Relationships

Evidence topics

contributes_evidence

Editorial context

Why this study matters

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Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 72

Why it is useful

Contributes to 7 evidence relationships
Includes primary outcome data
Linked to 3 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Metformin + Liraglutide → Relative abundance of Streptococcus thermophilus

Evidence profile

StrongDecreaseMetabolic Health

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Evidence Suggest

Metformin significantly increased Eubacterium and Eubacterium rectale (p < 0.05).
Metformin correlated with lower fasting plasma glucose levels (r = -0.7, p < 0.05).
The combination treatment altered the abundance of specific gut bacteria significantly.

Who this applies to

Youth diagnosed with type 2 diabetes.
Patients undergoing treatment with Metformin or Liraglutide.

Keep in Mind

Results may not apply to adults or other populations with diabetes.
The study focused on short-term effects; long-term implications are unknown.
Further research is needed to explore the mechanisms behind these microbiome changes.

Between the Lines

The study's sample size may limit the generalizability of the findings.
The long-term effects of these treatments on gut microbiome and metabolic health remain unclear.
Potential confounding factors were not fully controlled for in the analysis.

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Metformin Therapies and Fasting Glucose, Metformin Therapies and Plasma cholic secondary bile acids.

Related evidence relationships

Explore in Evidence Archive

This study contributes to the evidence on the following intervention-outcome relationships.

Metformin TherapiesFasting Glucose

Medications

2 studies

Detailed evidence

Metformin TherapiesPlasma cholic secondary bile acids

Medications

1 studies

Detailed evidence

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Fasting Glucose Evidence Hub

All studies measuring Fasting Glucose

2 studies

outcome_hub

Measures Fasting Glucose as a key outcome.

Metformin Therapies Evidence Hub

All studies on Metformin Therapies

2 studies

intervention_hub

Contributes to Metformin Therapies evidence base.

Plasma cholic secondary bile acids Evidence Hub

All studies measuring Plasma cholic secondary bile acids

1 studies

outcome_hub

Measures Plasma cholic secondary bile acids as a key outcome.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Generated from the study's connected evidence using Evidence Intelligence™.

Does Metformin Therapies improve fasting glucose?

Emerging Evidence

Metformin Therapies appears to improve Fasting Glucose.

ConsensusScore™: Results are consistent across studies.

Ranked evidence signals

1
Fasting Plasma Glucose (FPG)
EvidenceScore™ Emerging | EvidenceScore™ 57.3 | strong positive | ConsensusScore™ Consistent | 1 study

Why this answer: This answer is based on 3 supporting studies with consistent results and a positive effect signal.

Limitations

Population details are unavailable.

View Full Evidence

Does Metformin improve plasma cholic secondary bile acids?

Emerging Evidence

Metformin appears to improve Plasma cholic secondary bile acids.

ConsensusScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Plasma cholic secondary bile acids
EvidenceScore™ Emerging | EvidenceScore™ 51.7 | strong positive | ConsensusScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Metformin improve relative abundance of bacteroides ovatus?

Emerging Evidence

Metformin appears to improve Relative abundance of Bacteroides ovatus.

ConsensusScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Relative abundance of Bacteroides ovatus
EvidenceScore™ Emerging | EvidenceScore™ 51.7 | strong positive | ConsensusScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Metformin improve relative abundance of eubacterium?

Emerging Evidence

Metformin appears to improve Relative abundance of Eubacterium.

ConsensusScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Relative abundance of Eubacterium
EvidenceScore™ Emerging | EvidenceScore™ 51.7 | strong positive | ConsensusScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

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Next steps

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Evidence topics

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Glycemic Control Evidence Hub Metformin Evidence Hub Liraglutide Evidence Hub

Explore in archive

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All studies on Metformin and Fasting Plasma Glucose (FPG)All studies on Metformin and Plasma cholic secondary bile acids All studies on Metformin and Relative abundance of Bacteroides ovatus All studies on Metformin and Relative abundance of Eubacterium

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