Gut Bacterium Bilophila wadsworthia impeded lifestyle intervention response in Gestational Diabetes Mellitus

Lifestyle intervention is the preferred treatment for gestational diabetes mellitus (GDM) threating to both the mother and infant. However, a high proportion of the patients are non-responders, and the underlying mechanism is unclear. Here, we collect fecal, blood from GDM patients undergoing lifestyle intervention, and find Bilophila, especially Bilophila wadsworthia (BW), suppresses the response of GDM patients to lifestyle interventions by activating inflammatory pathway related to GDM. In addition, we demonstrate Lactobacillus rhamnosus (LR) is a potential treatment for non-responders by inhibiting host glucose metabolism and repair inflammatory damage driven by Bilophila wadsworthia. All of these findings are further evidenced by animal experiments. In summary, we provide potential strategies for the GDM management and treatment, which will be beneficial to a large proportion of GDM patients.