Conclusions
Metformin-induced
Metformin-induced side effects are an important clinical problem in Y-T2DM. This innovative study found that adjunctive prebiotic treatment was well tolerated and facilitated timely dose escalation without inducing GI side effects. Metformin alone and the prebiotic-metformin combination resulted in unique shifts in the beta-diversity of the microbiome that were detectable under controlled feeding conditions and in the free-living environment. Prebiotics should be considered in larger trials to evaluate their effectiveness in mitigating GI side effects and improving metabolisms and quality of life in a broader population of youth.