Abstract
Diabetes mellitus has been a common metabolic disorder in recent years across the world. It has affected approximately 463 million people worldwide, which has tripled in the last two decades. It has been forecasted to show an upward trend through 2030 and 2045 in China, India, and the United States. Few studies have been done to assess the impact of gut microbiota on human. Diabetes mellitus is found to have an association with gut microbiota. Few animal studies are available linking the alteration of gut microbiota in diabetes mellitus. Probiotics have been found to have anti-diabetic properties. If diabetes is treated with diet modification in addition to drugs, it could change the spectrum of intestinal bacteria by boosting commensal bacteria and decreasing the harmful bacteria in the microbiome population of the gastrointestinal tract, which is highly beneficial. This could aid diabetics in managing diabetes mellitus and its complications effectively. This review has been undertaken to address the management of diabetes mellitus with a focus on the gut microbiome in addition to antidiabetic medications.
[1]
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N. IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas,9th edition. Diabetes Res Clin Pract. 2019; 157: p. 107843.
[2]
Saeedi P, Salpea P, Karuranga S, et al. Mortality attributable to
diabetes in 20–79 years old adults, 2019 estimates: Results from
the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2020; 162: 108086.
[http://dx.doi.org/10.1016/j.diabres.2020.108086] [PMID: 32068099]
[http://dx.doi.org/10.1016/j.diabres.2020.108086] [PMID: 32068099]
[3]
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018; 14(2): 88-98.
[http://dx.doi.org/10.1038/nrendo.2017.151] [PMID: 29219149]
[http://dx.doi.org/10.1038/nrendo.2017.151] [PMID: 29219149]
[4]
Sharma S, Tripathi P. Gut microbiome and type 2 diabetes: Where we are and where to go? J Nutr Biochem 2019; 63: 101-8.
[http://dx.doi.org/10.1016/j.jnutbio.2018.10.003] [PMID: 30366260]
[http://dx.doi.org/10.1016/j.jnutbio.2018.10.003] [PMID: 30366260]
[5]
Zhang Y, Gu Y, Ren H, et al. Gut microbiome-related effects of berberine and probiotics on type 2 diabetes (the PREMOTE study). Nat Commun 2020; 11(1): 5015.
[http://dx.doi.org/10.1038/s41467-020-18414-8] [PMID: 33024120]
[http://dx.doi.org/10.1038/s41467-020-18414-8] [PMID: 33024120]
[6]
American Diabetes Association. 2. classifcation and diagnosis of diabetes: Standards of medical care in diabetes-2020. Diabetes Care 2020; 43(S1): S14-31.
[http://dx.doi.org/10.2337/dc20-S002] [PMID: 31862745]
[http://dx.doi.org/10.2337/dc20-S002] [PMID: 31862745]
[7]
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37(S1): S81-90.
[http://dx.doi.org/10.2337/dc14-S081] [PMID: 24357215]
[http://dx.doi.org/10.2337/dc14-S081] [PMID: 24357215]
[8]
Rivière A, Selak M, Lantin D, Leroy F, De Vuyst L. Bifidobacteria and butyrate-producing colon bacteria: Importance and strategies for their stimulation in the human gut. Front Microbiol 2016; 7: 979.
[http://dx.doi.org/10.3389/fmicb.2016.00979] [PMID: 27446020]
[http://dx.doi.org/10.3389/fmicb.2016.00979] [PMID: 27446020]
[9]
Brown CT, Davis-Richardson AG, Giongo A, et al. Gut microbiome metagenomics analysis suggests a functional model for the development of autoimmunity for type 1 diabetes. PLoS One 2011; 6(10): e25792.
[http://dx.doi.org/10.1371/journal.pone.0025792] [PMID: 22043294]
[http://dx.doi.org/10.1371/journal.pone.0025792] [PMID: 22043294]
[10]
Vatanen T, Franzosa EA, Schwager R, et al. The human gut microbiome in early-onset type 1 diabetes from the TEDDY study. Nature 2018; 562(7728): 589-94.
[http://dx.doi.org/10.1038/s41586-018-0620-2] [PMID: 30356183]
[http://dx.doi.org/10.1038/s41586-018-0620-2] [PMID: 30356183]
[11]
Stewart CJ, Ajami NJ, O’Brien JL, et al. Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature 2018; 562(7728): 583-8.
[http://dx.doi.org/10.1038/s41586-018-0617-x] [PMID: 30356187]
[http://dx.doi.org/10.1038/s41586-018-0617-x] [PMID: 30356187]
[12]
Uusitalo U, Liu X, Yang J, et al. Association of early exposure of probiotics and islet autoimmunity in the TEDDY study. JAMA Pediatr 2016; 170(1): 20-8.
[http://dx.doi.org/10.1001/jamapediatrics.2015.2757] [PMID: 26552054]
[http://dx.doi.org/10.1001/jamapediatrics.2015.2757] [PMID: 26552054]
[13]
Muhammad U. Role of the gastrointestinal tract microbiome in the pathophysiology of diabetes mellitus. J Diabetes Res 2017; 2017: 9631435.
[14]
Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science 2012; 336(6086): 1268-73.
[http://dx.doi.org/10.1126/science.1223490]
[http://dx.doi.org/10.1126/science.1223490]
[15]
Bleich A, Hansen AK. Time to include the gut microbiota in the hygienic standardisation of laboratory rodents. Comp Immunol Microbiol Infect Dis 2012; 35(2): 81-92.
[http://dx.doi.org/10.1016/j.cimid.2011.12.006] [PMID: 22257867]
[http://dx.doi.org/10.1016/j.cimid.2011.12.006] [PMID: 22257867]
[16]
Turnbaugh PJ, Bäckhed F, Fulton L, Gordon JI. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe 2008; 3(4): 213-23.
[http://dx.doi.org/10.1016/j.chom.2008.02.015]
[http://dx.doi.org/10.1016/j.chom.2008.02.015]
[17]
Cani PD, Neyrinck AM, Fava F, et al. Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia 2007; 50(11): 2374-83.
[http://dx.doi.org/10.1007/s00125-007-0791-0] [PMID: 17823788]
[http://dx.doi.org/10.1007/s00125-007-0791-0] [PMID: 17823788]
[18]
Shi H, Kokoeva MV, Inouye K, Tzameli I, Yin H, Flier JS. TLR4 links innate immunity and fatty acid–induced insulin resistance. J Clin Invest 2006; 116(11): 3015-25.
[http://dx.doi.org/10.1172/JCI28898] [PMID: 17053832]
[http://dx.doi.org/10.1172/JCI28898] [PMID: 17053832]
[19]
Liu H, Wang J, He T, et al. Butyrate: A double-edged sword for health? Adv Nutr 2018; 9(1): 21-9.
[http://dx.doi.org/10.1093/advances/nmx009] [PMID: 29438462]
[http://dx.doi.org/10.1093/advances/nmx009] [PMID: 29438462]
[20]
Sun KY, Xu DH, Xie C, et al. Lactobacillus paracasei modulates LPS-induced inflammatory cytokine release by monocyte-macrophages via the up-regulation of negative regulators of NF-kappaB signaling in a TLR2-dependent manner. Cytokine 2017; 92: 1-11.
[http://dx.doi.org/10.1016/j.cyto.2017.01.003] [PMID: 28088611]
[http://dx.doi.org/10.1016/j.cyto.2017.01.003] [PMID: 28088611]
[21]
McNabney S, Henagan T. Short chain fatty acids in the colon and peripheral tissues: A focus on butyrate, colon cancer, obesity and insulin resistance. Nutrients 2017; 9(12): 1348.
[http://dx.doi.org/10.3390/nu9121348] [PMID: 29231905]
[http://dx.doi.org/10.3390/nu9121348] [PMID: 29231905]
[22]
Fraher MH, O’Toole PW, Quigley EMM. Techniques used to characterize the gut microbiota: A guide for the clinician. Nat Rev Gastroenterol Hepatol 2012; 9(6): 312-22.
[http://dx.doi.org/10.1038/nrgastro.2012.44] [PMID: 22450307]
[http://dx.doi.org/10.1038/nrgastro.2012.44] [PMID: 22450307]
