Spotlight on gut microbiota in diabetes

Several recent articles addressed the role of the gut microbiota in diabetes.

One article reported on a forum that gathered investigators in the field of the intestinal microbiome and metabolism in Germany last year. The experts concluded that gut microbiota "may be involved in the pathophysiology of type 2 diabetes, as microbially produced metabolites associate both positively and negatively with the disease." They noted that the individual variety of gut microbiota poses a major obstacle to research and they called for studies that repeatedly measure microbiota over time in the same patients. The forum summary also discusses potential diagnostic tools and therapies for diabetes based on gut microbiota, including special diets, probiotics, and fecal transplants. It was published on June 24 by Diabetes Care, Diabetes, and Diabetologia. An accompanying editorial explained that the forum was jointly organized by the American Diabetes Association and European Association for the Study of Diabetes and funded by the Novo Nordisk Foundation.

A study published by Nature Medicine on June 25 offered a comprehensive analysis of the microbiome as it relates to type 2 diabetes. Researchers analyzed 8,117 shotgun metagenomes of people with type 2 diabetes, prediabetes, or normoglycemia in the U.S., Europe, Israel, and China. They found dysbiosis in 19 phylogenetically diverse species that was associated with diabetes, with micro-organisms that contributed to functional changes and potentially the underlying pathogenesis of type 2 diabetes. The study also identified 27 examples of within-species phylogenetic diversity that could explain individual-level differences in diabetes risk. "Although our study does not establish causal linkages and should be interpreted as hypothesis generating, it offers the most comprehensive evidence to date of the gut microbiome's involvement in the pathogenesis of T2D [type 2 diabetes] from the population study perspective," the study authors wrote. "Our findings provide evidence for the gut microbiome's potential functional role in the pathogenesis of T2D, and highlight the identification of taxonomic and functional biomarkers for future diagnostic applications."

Finally, a narrative review published by Nutrients on June 19 provided an overview of current knowledge on the association of type 2 diabetes with microbiota, explaining how gut microbiota can influence glucose and lipid metabolism and insulin sensitivity. "Interventions focusing on the gut microbiota are gaining traction as a promising approach to diabetes management. Studies are currently being conducted on the effects of the supply of probiotics and prebiotics, as well as fecal microbiota transplantation, on the course of diabetes," said the review authors, who expressed optimism that the results of such research would lead to new strategies for preventing and treating diabetes.