Gut microbiota in the pathogenesis and therapeutic approaches of diabetes

Crudele, Lucilla; Gadaleta, Raffaella Maria; Cariello, Marica; Moschetta, Antonio

doi:10.1016/j.ebiom.2023.104821

Cited by 63 publications

(18 citation statements)

References 69 publications

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“…Thiazolidinedione medications may alter the balance of gut microbiota [ 100 ]. These compounds have the ability to decrease insulin resistance in adipose tissue, muscles, and the liver [ 101 ].…”

Section: Discussionmentioning

confidence: 99%

Interactions between Gut Microbiota and Oral Antihyperglycemic Drugs: A Systematic Review

Mindrescu,

Guja,

Jinga

et al. 2024

IJMS

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The intestinal microbiota refers to the collection of microorganisms that exist in the human gut. It has been said that bacteria influence the development of metabolic diseases, such as diabetes mellitus, as they have roles in immunomodulation, protection against pathogens, blood vessel growth, repairing the intestinal wall, and the development of the neurological system. In this review, we look at the latest research regarding interactions between gut microbiota and oral antihyperglycemic drugs and we present data suggesting that the microbiome may help counteract the reduced glucose tolerance and insulin resistance associated with metabolic disorders. We found that antidiabetic drugs can have significant impacts on gut microbiota composition and function, potentially influencing both the efficacy and side effects of these medications. Additionally, we discovered that microbial-based therapeutics, including probiotics, prebiotics, and postbiotics, and fecal microbiota can be considered when discussing preventive measures and personalized treatment options for type 2 diabetes mellitus. Understanding how antidiabetic drugs modulate gut microbiota composition and function is essential for optimizing their therapeutic efficacy and minimizing potential adverse effects. The relationship between the gut microbiota and glycemic agents, not fully understood, is currently the subject of increasing research and discussion. It has been proven that the microbiome can impact the effectiveness of the medications, but further research in this field may uncover novel therapeutic strategies for diabetes and other metabolic disorders by targeting the gut microbiota.

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Section: Discussionmentioning

confidence: 99%

Interactions between Gut Microbiota and Oral Antihyperglycemic Drugs: A Systematic Review

Mindrescu,

Guja,

Jinga

et al. 2024

IJMS

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show abstract

“…As a potentially pro‐inflammatory species, Fusobacterium could induce low‐grade systemic inflammation, 36,37 thereby causing hepatic and peripheral insulin resistance, and glucose metabolism disorders 21,38 . Therefore, interventions such as mouthwash and probiotic supplements might be a solution to reduce microbiome‐related side effects of PPIs, such as diabetes, but the potential effects warrant further study 39,40 …”

Section: Discussionmentioning

confidence: 99%

Alterations in gut microbiota and bile acids by proton‐pump inhibitor use and possible mediating effects on elevated glucose levels and insulin resistance

He,

Xia,

Yang

et al. 2024

The FASEB Journal

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Several observational studies have suggested that proton‐pump inhibitor (PPI) use might increase diabetes risk, but the mechanism remains unclear. This study aimed to investigate the effects of PPI use on gut microbiota and bile acids (BAs) profiles, and to explore whether these changes could mediate the association of PPIs use with fasting blood glucose (FBG) levels and insulin resistance (IR) in Chinese population. A cross‐sectional study was conducted in Shenzhen, China, from April to August 2021, enrolled 200 eligible patients from the local hospital. Participants completed a questionnaire and provided blood and stool samples. Gut microbiome was measured by16S rRNA gene sequencing, and bile acids were quantified by UPLC‐MS/MS. Insulin resistance (IR) was assessed using the Homeostasis Model Assessment 2 (HOMA2‐IR). PPI use was positively associated with higher levels of FBG and HOMA2‐IR after controlling for possible confounders. PPI users exhibited a decreased Firmicutes and an increase in Bacteroidetes phylum, alongside higher levels of glycoursodeoxycholic acid (GUDCA) and taurochenodeoxycholic acid (TCDCA). Higher abundances of Bacteroidetes and Fusobacterium as well as higher levels of TCDCA in PPI users were positively associated with elevated FBG or HOMA2‐IR. Mediation analyses indicated that the elevated levels of FBG and HOMA2‐IR with PPI use were partially mediated by the alterations in gut microbiota and specific BAs (i.e., Fusobacterium genera and TCDCA). Long‐term PPI use may increase FBG and HOMA2‐IR levels, and alterations in gut microbiota and BAs profiles may partially explain this association.

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“…Therefore, DM is associated with enteric dysbacteriosis, which damages the intestinal mucosal barrier and increases intestinal permeability. When the metabolite lipopolysaccharide (LPS) is translocated and released into the blood through a leaky intestinal mucosal barrier, a large amount of endotoxin is produced, which damages the function of islet β-cells, produces immune inflammation, activates macrophages, leads to vascular inflammation, and participates in the occurrence of DM ( Zhang et al., 2021 ; Del Chierico et al., 2022 ; Guo et al., 2022 ; Lin et al., 2022 ; Zhou et al., 2022 ; Crudele et al., 2023 ; Wang et al., 2023 ; Wu et al., 2023 ) ( Figure 3 ).…”

Section: Gut Microbiota and Dmmentioning

confidence: 99%

“…Therefore, when the floral structure is relatively stable, it does not cause disease in the host. Existing literature shows that gut microbiota diversity in patients with diabetes is reduced, and the ratio of firmicutes to bacteroides is significantly reduced ( Schloissnig et al., 2013 ; Zhang et al., 2021 ; Del Chierico et al., 2022 ; de Vos et al., 2022 ; Guo et al., 2022 ; Zhou et al., 2022 ; Crudele et al., 2023 ; Wu et al., 2023 ). Human health is closely related to the structure of probiotics in the gut, such as bifidobacterium , which is negatively correlated with blood sugar, blood pressure, lipids, and body mass index.…”

Section: Fmt Used To Treat Dmmentioning

confidence: 99%

“…The gut microbiota is the most abundant group of antigen-presenting cells (APCs) ( Adak and Khan, 2019 ), and their imbalance disrupts immunity and homeostasis. By introducing environmental antigens into the gastrointestinal tract, the gut microbiota interferes with the reaction between antigens and the host immune system, resulting in increased intestinal permeability and the development of diabetes ( Del Chierico et al., 2022 ; Guo et al., 2022 ; Zhou et al., 2022 ; Crudele et al., 2023 ; Wu et al., 2023 ).…”

Section: Introductionmentioning

confidence: 99%

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Advances in fecal microbiota transplantation for the treatment of diabetes mellitus

Zhang,

Wang,

Liu

et al. 2024

Front. Cell. Infect. Microbiol.

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Diabetes mellitus (DM) refers to a group of chronic diseases with global prevalence, characterized by persistent hyperglycemia resulting from various etiologies. DM can harm various organ systems and lead to acute or chronic complications, which severely endanger human well-being. Traditional treatment mainly involves controlling blood sugar levels through replacement therapy with drugs and insulin; however, some patients still find a satisfactory curative effect difficult to achieve. Extensive research has demonstrated a close correlation between enteric dysbacteriosis and the pathogenesis of various types of DM, paving the way for novel therapeutic approaches targeting the gut microbiota to manage DM. Fecal microbiota transplantation (FMT), a method for re-establishing the intestinal microbiome balance, offers new possibilities for treating diabetes. This article provides a comprehensive review of the correlation between DM and the gut microbiota, as well as the current advancements in FMT treatment for DM, using FMT as an illustrative example. This study aims to offer novel perspectives and establish a theoretical foundation for the clinical diagnosis and management of DM.

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Gut microbiota in the pathogenesis and therapeutic approaches of diabetes

Cited by 63 publications

References 69 publications

Interactions between Gut Microbiota and Oral Antihyperglycemic Drugs: A Systematic Review

Interactions between Gut Microbiota and Oral Antihyperglycemic Drugs: A Systematic Review

Alterations in gut microbiota and bile acids by proton‐pump inhibitor use and possible mediating effects on elevated glucose levels and insulin resistance

Advances in fecal microbiota transplantation for the treatment of diabetes mellitus

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