Effect of 4 Weeks of Oral Probiotic Desulfovibrio Piger Supplementation on Immunological and Metabolic Parameters in Individuals With Longstanding Type 1 Diabetes

Prior treatment

• Use of antibiotics or proton-pump inhibitors within the last three months before screening or during study period
• Use of other probiotic supplementation within the last month before screening or during study period
• Smoking or illicit drug use (e.g. MDMA/amphetamine/cocaine/heroin/GHB) in the past three months or use during the study period.

Other illness

• A history of cholecystectomy
• Overt untreated gastrointestinal disease, inflammatory bowel disease or abnormal bowel habits
• Evidence for comprised immunity (HIV infection, chemotherapy, other autoimmune diseases, systemic anti-inflammatory therapy)
• History of cardiovascular disaeses (CVD) events

Lab values

• Kidney failure (eGFR \<15ml.min/1.73m2), dialysis, kidney transplantation,

Other

• Absence of a large bowel (ie colostomy)
• Hepatic enzymes\>2.5 higher than the upper limit of normal range, determined during MARVEL visits/routine visits
• Inability or unwillingness to donate feces or urine.
• Alcohol abuse (equal or above 21 units per week)
• Inability or unwillingness to provide informed consent.

• Males or females, age \>18 years
• A diagnosis of type 1 diabetes, with duration of more than 5 years, with minimally one of antiGAD65, IA2, ZnT8 autoantibodies present assessed at diagnosis or routine visits at Diabeter Centrum.
• Evidence of remaining residual beta cell function with detectable UCPCR (more than 0.01 nmol/mmol C-peptide/creatinine ratio) and or fasting plasma C-peptide more than 0.2 mmol/L.
• BMI 18-30 kg/m2