Targeting the gut microbiota in type 1 diabetes mellitus: Therapeutic potential of probiotics and prebiotics

Type 1 diabetes mellitus (T1DM) management faces limitations with conventional insulin therapy, prompting exploration of novel strategies targeting gut microbiota dysregulation. Accumulating evidence indicates that gut microbial alterations significantly compromise intestinal barrier integrity and immune homeostasis, contributing to T1DM pathogenesis. Probiotics and prebiotics emerge as promising modulators of gut-islet axis function, though their mechanisms for restoring mucosal tolerance require further elucidation. Persistent translational challenges include strain specificity and treatment individualization. This review synthesizes evidence on microbiota-β cell-immune interactions to establish a framework for targeted microbial therapeutics in T1DM.