Repeated faecal microbiota transplantation for individuals with type 1 diabetes and gastroenteropathy – Published online 18/09/2025

Katrine L. Høyer, Ditte S. Kornum, Simon M. D. Baunwall, Mette W. Klinge, Asbjørn M. Drewes, Knud B. Yderstræde, Susan Mikkelsen, Christian Erikstrup, Klaus Krogh, Christian L. Hvas

Individuals with type 1 diabetes experience frequent and often disabling gastrointestinal complications, but treatment options remain limited. These symptoms, driven by nerve damage in the gut, include abdominal pain, bloating and unpredictable diarrhoea or constipation and can severely affect daily life. In this issue, Høyer et al (https://doi.org/10.1007/s00125-025-06544-x) report the findings from an open-label extension study that followed participants from a previous randomised trial who had already received faecal microbiota transplantation (FMT). In total, 17 of the 20 participants from the randomised trial were offered repeated FMT whenever symptoms recurred. Over nearly 3 years and 95 treatments, FMT, at an average of one treatment every 5 months, consistently eased symptoms and improved stool patterns. The authors highlight that side effects were mild and only one serious complication was possibly treatment related. The authors conclude that these findings provide the first long-term evidence that repeated, on-demand FMT can provide safe and sustained relief for otherwise difficult-to-treat gastrointestinal complications in type 1 diabetes.

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