FMT alleviates peripheral neuropathy in patients with diabetes mellitus

Emerging evidence shows that gut microbiota drives the development of diabetes mellitus (DM). However, the contribution of gut microbiota to diabetic peripheral neuropathy (DPN), a common complication of DM, remains elusive. Here, our randomized, double- blind, placebo-controlled pilot clinical trial showed that fecal microbiota transplantation (FMT) significantly increased both the sensory and motor nerve conduction velocities and alleviated neuropathic symptoms and signs, particularly neuropathic pain. FMT did not improve glycemic control but significantly altered the gut microbiota, which had increased capacity for butyrate production and decreased for endotoxin. Such alterations were accompanied by improved gut barrier integrity and decreased proinflammatory cytokine levels. Thus, gut microbiota may play a causative role in DPN, and become an effective target for treatment.