D3.391 - The Effect of Bicarbonate Mineral Water on Endotoxemia Markers in Patients with Type 1 Diabetes Mellitus

 Endotoxemia plays a significant role in systemic inflammation by activating Toll-like receptors (TLR4). In type 1 diabetes mellitus (T1DM) patients, hyperglycemia can directly damage the intestinal barrier, increasing  permeability to endotoxins. Non-pharmacological interventions, such as the use of natural mineral waters are a promising approach to modulate gut permeability. However, the specific effect of these waters on endotoxemia markers in T1DM has not been previously studied.

The study evaluated the effect of mineral water on endotoxin-binding systems and inflammation markers in patients with T1DM. Patients consumed Crimean mineral water for 30 days. Levels of C-reactive protein (CRP), lipopolysaccharide (LPS) and LPS-binding protein (LBP) were measured before and after the intervention. A control group was observed over the same period, and its participants did not receive mineral water.

 After 30 days of intervention, the mineral water group showed a statistically significant decrease in circulating LPS levels (from a median of 125.5 to 92.3 ng/mL, p=0.039). Concurrently, LBP levels significantly increased (from 6.83 to 8.62 mg/L, p=0.009). No statistically significant changes were found in the control group for any of these parameters over the 30-day period (p>0.05).

Mineral water demonstrated efficacy in reducing the level of circulating LPS in patients with T1DM. This intervention can be considered a safe component of diet therapy for T1DM to correct endotoxemia and associated inflammation. This effect is associated with the modulation of endotoxin-neutralizing systems, as reflected by the increase in LBP.