The role of the microbiome in diabetes mellitus

Zhang, Shili; Cai, Yong; Meng, Chuzhen; Ding, Xinyi; Huang, Jinhong; Luo, Xiang‐Qian; Cao, Ying; Gao, Fang; Zou, Mengchen

doi:10.1016/j.diabres.2020.108645

Cited by 63 publications

(50 citation statements)

References 80 publications

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“…The significant increase in viable bacteria found on skin from participants with diabetes, particularly on the thigh, is conspicuous. Metabolic alterations such as perturbed thermoregulatory function, adjusted sweat secretion, and increased surface pH may contribute to enriched conditions for microbial growth [35]. Comparably, significantly more anaerobic bacteria in participants with diabetes could suggest that such metabolic shifts foment anaerobic proliferation.…”

Section: Discussionmentioning

confidence: 99%

Injection site microflora in persons with diabetes: why needle reuse is not associated with increased infections?

Wareham-Mathiassen

Bay

Glenting

et al. 2022

APMIS

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SofiaWareham-Mathiassen, Bay L, Glenting VP, Fatima N, Bengtsson H, Bjarnsholt T. Injection site microflora in persons with diabetes: why needle reuse is not associated with increased infections?. APMIS. 2022; 130: 404-416. Needle reuse is a common practice and primary cause of customer compliance issues such as pain, bruising, clogging, injection site reactions (ISR), and associated lipodystrophy. This study aimed to characterize skin microflora at injection sites and establish microbial contamination of used pen injectors and needles. The second objective was to evaluate the risk of infections during typical and repeated subcutaneous injections. 50 participants with diabetes and 50 controls (n = 100) were sampled through tape strips and skin swabs on the abdomen and thigh for skin microflora. Used pen injectors and needles were collected after in-home use and from the hospital after drug administration by health care professionals (HCPs). Samples were analyzed by conventional culture, matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF), mass spectrometry (MS), confocal laser scanning microscopy (CLSM), and 16S/ITS high throughput sequencing (HTS). A mathematical model simulated the risk of needle contamination during injections. Injection site populations were in 10 2 cells/cm 2 order, with increased viable bacteria and anaerobic bacteria on the skin in persons with diabetes (p = 0.05). Interpersonal variation dominated other factors such as sex or location. A higher prevalence of Staphylococcus aureus on abdominal skin was found in persons with diabetes than control skin (p ≤ 0.05). Most needles and cartridges (95% and 86%) contained no biological signal. The location of the device collection (hospital vs home-use) and use regimen did not affect contamination. CLSM revealed scarcely populated skin microflora scattered in aggregates, diplo, or single cells. Our mathematical model demonstrated that penetrating bacteria colonies during subcutaneous injection is unlikely. These findings clarify the lack of documented skin infections from subcutaneous insulin injections in research. Furthermore, these results can motivate the innovation and development of durable, reusable injection systems with pharmacoeconomic value and a simplified and enhanced user experience for patients.

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Section: Discussionmentioning

confidence: 99%

Injection site microflora in persons with diabetes: why needle reuse is not associated with increased infections?

Wareham-Mathiassen

Bay

Glenting

et al. 2022

APMIS

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“…Recently, endotoxin secretion from Gram-negative bacteria has been observed in diabetes patients and it is likely to induce insulin inefficiency through the elevation of pro-inflammatory cytokines in the adipocytes such as TNF-α [ 154 ]. During the pathogenesis of chronic wounds, an infection caused by S. aureus increases glucose resistance by blocking the insulin to its target site hence elevating the glucose level in the blood [ 155 ]. Besides that, biofilms’ continuous presence could delay wound healing in the DFU by releasing the inflammatory cytokines, free radicals, nitric oxide, and complement initiation through the activation of immune cells [ 156 ] as shown in Figure 5 .…”

Section: The Role Of Microbes In Wound Healingmentioning

confidence: 99%

The Insights of Microbes’ Roles in Wound Healing: A Comprehensive Review

2021

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A diverse range of normal flora populates the human skin and numbers are relatively different between individuals and parts of the skin. Humans and normal flora have formed a symbiotic relationship over a period of time. With numerous disease processes, the interaction between the host and normal flora can be interrupted. Unlike normal wound healing, which is complex and crucial to sustaining the skin’s physical barrier, chronic wounds, especially in diabetes, are wounds that fail to heal in a timely manner. The conditions become favorable for microbes to colonize and establish infections within the skin. These include secretions of various kinds of molecules, substances or even trigger the immune system to attack other cells required for wound healing. Additionally, the healing process can be slowed down by prolonging the inflammatory phase and delaying the wound repair process, which causes further destruction to the tissue. Antibiotics and wound dressings become the targeted therapy to treat chronic wounds. Though healing rates are improved, prolonged usage of these treatments could become ineffective or microbes may become resistant to the treatments. Considering all these factors, more studies are needed to comprehensively elucidate the role of human skin normal flora at the cellular and molecular level in a chronic injury. This article will review wound healing physiology and discuss the role of normal flora in the skin and chronic wounds.

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“…The gut microbiota consists of a large number of cells that are known as the body's second gene pool and form a complex symbiotic relationship with the host (Zhou et al, 2020). The intestinal microbiota plays a key role in maintaining healthy host homeostasis, and imbalances in its composition often involve in immune and metabolic disorders, such as colitis (Glassner, Abraham, & Quigley, 2020) and T2DM (Zhang et al, 2021a). Decreased diversity and imbalanced composition in the gut microbiota are typical of patients with CD and UC (Alam et al, 2020), the relative abundance of the beneficial bacteria Candidatus_Saccharimonas (Ge et al, 2021) and Eubacterium_xylanophilum_group were significantly reduced.…”

Section: Introductionmentioning

confidence: 99%

Curcumin regulates the homeostasis of Th17/Treg and improves the composition of gut microbiota in type 2 diabetic mice with colitis

Xiao

Zhong

Kang

et al. 2022

Phytotherapy Research

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Diabetes mellitus (DM) is one of the most common complications in patients with ulcerative colitis (UC). Curcumin has a wide range of bioactive and pharmacological properties and is commonly used as an adjunct to the treatment of UC and DM.However, the role of curcumin in UC complicated by DM has not been elucidated.Therefore, this study was conducted to construct a model of UC complicating diabetes by inducing UC in DB mice (spontaneously diabetic) with dextran sodium sulfate.In this study, curcumin (100 mg/kg/day) significantly improved the symptoms of diabetes complicated by UC, with a lower insulin level, heavier weight, longer and lighter colons, fewer mucosal ulcers and less inflammatory cell infiltration. Moreover, compared to untreated DB mice with colitis, curcumin-treated mice showed weaker Th17 responses and stronger Treg responses. In addition, curcumin regulated the diversity and relative abundance of intestinal microbiota in mice with UC complicated by DM at the phylum, class, order, family and genus levels. Collectively, curcumin effectively alleviated colitis in mice with type 2 diabetes mellitus by restoring the homeostasis of Th17/Treg and improving the composition of the intestinal microbiota

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The role of the microbiome in diabetes mellitus

Cited by 63 publications

References 80 publications

Injection site microflora in persons with diabetes: why needle reuse is not associated with increased infections?

Injection site microflora in persons with diabetes: why needle reuse is not associated with increased infections?

The Insights of Microbes’ Roles in Wound Healing: A Comprehensive Review

Curcumin regulates the homeostasis of Th17/Treg and improves the composition of gut microbiota in type 2 diabetic mice with colitis

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