Role of gut microbiota in Type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterized by persistent hyperglycaemia and insulin resistance. Its global prevalence has risen to epidemic levels, affecting approximately 463 million adults in 2019. Conventional treatment strategies, including lifestyle modifications, oral antidiabetic medications, and insulin therapy, often come with side effects and may not always ensure adequate glycaemic control. Recent studies have increasingly focused on the gut microbiota as a critical factor in the pathogenesis, management of T2DM. Dysbiosis has been linked to various metabolic disorders, including insulin resistance, obesity, and T2DM. Key mechanisms through which gut microbiota influence metabolic health include alterations in microbial diversity, disruption of gut barrier integrity, oxidative stress and modulation of immune responses. These changes foster a pro-inflammatory state, leading to systemic inflammation, further exacerbating insulin resistance. Specific bacterial taxa, such as Akkermansia muciniphila and Faecalibacterium prausnitzii, have emerged as potential markers for T2DM, reflecting the interplay between microbiota and metabolic function. Therapeutic strategies aimed at restoring gut microbiota balance, including the use of probiotics, prebiotics, and faecal microbiota transplantation (FMT), show promising results in enhancing glycaemic control and improving insulin sensitivity. Additionally, dietary interventions that promote beneficial microbial growth are gaining attention as effective measures for prevention and management of T2DM. This review explores the relationship between gut microbiota and T2DM, highlighting the underlying mechanisms of microbial influence on metabolic dysregulation in T2DM. It discusses the potential for gut microbiota composition to serve as a biomarker for early detection and targeted interventions in T2DM. More research is needed to elucidate the relationships between specific microbial taxa and T2DM, ultimately advancing our understanding and management of T2DM.