A microbiota‐based predictive model for type 2 diabetes remission induced by dietary intervention: From the CORDIOPREV study

Abstract

Dear Editor,Type 2 diabetes is widely considered as a chronic, progressive disease that is a consequence of the seemingly inexorable decline in β-cell function. 1 However, recent studies have demonstrated that in the early stages of development, it may be reversible. Indeed, in this regard, primary support derived from patients undergoing bariatric surgery has provided the earliest evidence of type 2 diabetes remission. In fact, the normalization of plasma glucose levels can occur in some patients just days after bariatric surgical intervention, and even before achieving significant weight loss. 2 This observation points to a relevant glucoregulatory role of the gastrointestinal tract. It has been proposed that a number of different, but not mutually exclusive, potential mechanisms may contribute toward this effect, including changes in bile acid metabolism, gastrointestinal tract nutrient sensing and glucose utilization, incretins, and gut microbiota. 3 Recent studies have shown that it is possible to induce type 2 diabetes remission by weight loss with calorie restriction interventions. 4 Depletion of the gut microbiota with antibiotic treatment and fecal microbiota transplantation suggest that the gut microbiota plays a causal role in the beneficial effects of calorie restriction, especially by lowering body weight and hepatic lipid accumulation. 5 Furthermore, it has been observed that calorie restriction and diabetes remission are associated with an improvement of gut permeability and a reduction in inflammatory and endotoxemia biomarkers. 6,7 Thus, it is noteworthy that the two approaches that, to date, are known to enable type 2 diabetes remission have plausibly suggested that a role is played by the gut microbiota. This idea is further strengthened by the reported association between this disease and the gut microbiota. Alterations in the gut microbiota of patients with type 2 diabetes have been described, 8 which adds to the potential causal relationship between the gut microbiome and This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The Specific Alteration of Gut Microbiota in Diabetic Kidney Diseases—A Systematic Review and Meta-Analysis

“…Recent studies suggest that lower alphadiversity and the characteristic of a pro-inflammatory environment in gut microbiota dysbiosis promote insulitis by activating and proliferating pancreatic-draining lymph node T cells, particularly diabetogenic CD8+ T cells, which may contribute to the risk of developing type 1 diabetes (T1D) in genetically predisposed individuals (9). In the case of type 2 diabetes (T2D), gut microbial taxa can serve as a biomarker for disease diagnosis (10) and predicting remission (11), which interact with dietary constituents to modulate inflammation, affect gut permeability, glucose and lipid metabolism, insulin sensitivity, and overall energy homeostasis, involving in the pathophysiology of T2D (12). DKD is one of the most common and serious complications of diabetes, and the emerging role of its gut microbiota has attracted wide attention and is considered an important factor affecting the occurrence and development of DKD.…”

Dietary licorice enhances in vivo cadmium detoxification and modulates gut microbial metabolism in mice

“…Additionally, flavonoids and quinones were also observed in the 235 differential metabolites (Figure 5C). The categories of amino acids (14), fatty acids (13), lineolic acids (10), terpene lactones (6), glycerophosphoethanolamines (6), bile acids and derivatives (6), and eicosanoids (6) were also among the top differential metabolites (Figure 5C). Furthermore, the above-mentioned 18 key differential gut microbial species correlated with the top 50 abundant differential metabolites.…”

“…Dietary interventions are the most practical approach for large‐scale health interventions [ 5 ]. In recent years, dietary interventions have been used for the prevention or treatment of Alzheimer's disease [ 6 ], endometriosis [ 6 ], weight gain in childhood, acute lymphoblastic leukemia [ 7 ], cardiovascular disease [ 8 ], depression [ 9 ], and type 2 diabetes [ 10 ]. For example, tea extracts have been preventing Alzheimer's disease by inhibiting acetylcholinesterase activity [ 11 ].…”

Corn silk polysaccharides attenuate diabetic nephropathy through restoration of the gut microbial ecosystem and metabolic homeostasis

“…Studies in recent years have also confirmed that the imbalance of gut microbiota involves many links from diabetes to diabetic nephropathy, such as insulin secretion disorder, advanced glycation end products, chronic inflammatory state, etc. ( 3 ), and the identification of intestinal microflora may be used as a biomarker for diagnosing and predicting diseases ( 4 , 5 ). However, the number of cells, bacteria and genes contained in the gut microbiota is very large, so its functional contribution to DN has not been systematically characterized.…”

“…(3), and the identification of intestinal microflora may be used as a biomarker for diagnosing and predicting diseases (4,5). However, the number of cells, bacteria and genes contained in the gut microbiota is very large, so its functional contribution to DN has not been systematically characterized.…”