Gut Microbiota and Complications of Type-2 Diabetes

Abstract

The gut microbiota has been linked to the emergence of obesity, metabolic syndrome and the onset of type 2 diabetes through decreased glucose tolerance and insulin resistance. Uncontrolled diabetes can lead to serious health consequences such as impaired kidney function, blindness, stroke, myocardial infarction and lower limb amputation. Despite a variety of treatments currently available, cases of diabetes and resulting complications are on the rise. One promising new approach to diabetes focuses on modulating the gut microbiota with probiotics, prebiotics, synbiotics and fecal microbial transplantation. Differences in gut microbiota composition have been observed in preclinical animal models as well as patients with type 2 diabetes and complications such as diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, cerebrovascular disease, coronary heart disease and peripheral artery disease compared to healthy controls. Severity of gut microbiota dysbiosis was associated with disease severity and restoration with probiotic administration in animal models and human patients has been associated with improvement of symptoms and disease progression. Characterizing the gut microbiota dysbiosis in different diseases and determining a causal relationship between the gut microbiota and disease can be beneficial in formulating therapeutic interventions for type 2 diabetes and associated complications. In this review, we present the most important findings regarding the role of the gut microbiota in type 2 diabetes and chronic complications as well as their underlying mechanisms.

Gut Microbiota Patterns Predicting Long-Term Weight Loss Success in Individuals with Obesity Undergoing Nonsurgical Therapy

“…Consistent with our findings, results from animal studies have shown that an increased abundance of R. intestinalis was associated with weight loss and reduced glucose intolerance [ 38 ]. In humans R. intestinalis was shown to be present at lower concentrations in individuals with type 2 diabetes compared to healthy subjects [ 39 , 40 , 41 , 42 ]. Similarly, Bacteroides stercoris (and likely also Bacteroides caccae ) have been identified as butyrate producers [ 43 ].…”

Identification of the DPP-IV Inhibitory Peptides from Donkey Blood and Regulatory Effect on the Gut Microbiota of Type 2 Diabetic Mice

“…Many studies have demonstrated that the development of diabetes is related to changes in the compositional profile of gut microbiota [ 38 ]. Our data indicated that the isolated and purified DPP-IV inhibitory peptides from donkey blood reduced the fasting glucose of type 2 diabetic mice.…”

Time‐limited diets and the gut microbiota in cardiometabolic disease

“…In addition, further research is needed to address the effect of the microbiome on additional organs such as the lung, skin, muscles, and kidneys, whose functions could also be influenced by IF diets 190–193 . Moreover, it remains to be determiced what is the role of the IF‐microbiome axis in several T2D‐related complications, such as the susceptibility to fungal infections, 194 diabetic foot ulcers, and diabetic nephropathy, which account for high morbidity and mortality rates in T2D patients 195 . Another question is whether a combination of IF with a defined diet composition or food choice consumed in eating days (eg, the aforementioned 5:2 DASH diet 147 ) can provide targeted benefits for certain CMD‐related conditions.…”

“… 190 , 191 , 192 , 193 Moreover, it remains to be determiced what is the role of the IF‐microbiome axis in several T2D‐related complications, such as the susceptibility to fungal infections, 194 diabetic foot ulcers, and diabetic nephropathy, which account for high morbidity and mortality rates in T2D patients. 195 Another question is whether a combination of IF with a defined diet composition or food choice consumed in eating days (eg, the aforementioned 5:2 DASH diet 147 ) can provide targeted benefits for certain CMD‐related conditions. In this respect, it is worth noting that although the nutrient composition of the diet has a tremendous effect on the gut microbiome, 196 the impact on CMD has not been elucidated.…”