DM frequency progressively increased across BMI classes in each SIBO status group and trended higher in H 2-SIBO(+) patients in the 35-40 BMI range ( Table 1). The frequency of DM was significantly higher in patients who were H 2-SIBO(+) (79/245, 32.2%) vs.
Body mass index (BMI) and DM ICD-10 codes were obtained from medical records. The presence of SIBO was determined using established consensus criteria. Gas production, a surrogate measure of bacterial colonization density, was determined by area under the time-concentration curves (AUC). All patients had undergone a standard testing protocol that involved administering a 50g oral glucose load obtaining breath samples at 15-min intervals for 2 hours and analyzing them for H 2 and CH 4 gas concentration. We queried a database of breath tests conducted for suspected SIBO at our tertiary medical center. Although the microbiome has been implicated in the etiologies of obesity and type 2 diabetes (DM), the impact of obesity and DM on SIBO is not well defined. The majority of patients with SIBO produce hydrogen (H 2) however, around 33% are colonized with methanogenic Archaea – anaerobic organisms that produce methane (CH 4) and are often resistant to standard antibiotics. However, in small intestinal bacterial overgrowth (SIBO), the bacterial population of the small bowel lumen can increase many log-fold. In the healthy gut, the vast majority of these bacteria inhabit the colon. The human gut microbiome is a complex ecosystem of around 100 trillion bacteria that resides in the lumen of the intestinal tract.
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