Role of Gut Microbiota on Onset and Progression of Microvascular Complications of Type 2 Diabetes (T2DM)

Abstract

Type 2 diabetes mellitus (T2DM) remains one of the most problematic and economic consumer disorders worldwide, with growing prevalence and incidence. Over the last years, substantial research has highlighted the intricate relationship among gut microbiota, dysbiosis and metabolic syndromes development. Changes in the gut microbiome composition lead to an imbalanced gastrointestinal habitat which promotes abnormal production of metabolites, inflammatory status, glucose metabolism alteration and even insulin resistance (IR). Short-chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO), lipopolysaccharide, aromatic amino acids and their affiliated metabolites, contribute to T2DM via different metabolic and immunologic pathways. In this narrative review, we discuss the immunopathogenic mechanism behind gut dysbiosis, T2DM development and the major known diabetic microvascular complications (retinopathy, neuropathy and nephropathy), the beneficial use of pre- and pro-biotics and fecal microbiota transplantation in T2DM management and new findings and future perspectives in this field.

Gut microbiota, key to unlocking the door of diabetic kidney disease

“… 54 Intestinal flora, such as Firmicutes, Proteobacteria, Clostridium asparagiforme , Escherichia fergusonii and Desulfovibrio desulfuricans , can produce trimethylamine N‐oxide (TMAO). 55 Escherichia coli can metabolize tryptophan into indole, which can, in turn, be converted into IS and Kyn in the liver. 56 Bacteroides , Bifidobacterium , Lactobacillus and Clostridium are all related to p‐cresyl sulphate (PCS) generation.…”

Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges

“…A complete analysis of available products (combinations may account for several hundreds) is outside the scope of this review, but a few of them are of interest. Their putative mechanism(s) of action are summarized in Table 3 [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]. They are not expected to replace diet and glucose-lowering drugs but might be confidently used, provided their safety is proven.…”

Peripheral Vascular Abnormalities in Anorexia Nervosa: A Psycho-Neuro-Immune-Metabolic Connection

“…The gut microbiota is mainly influenced by nutrition and obviously in AN selective eating and nutritional restriction are relevant influencing factors [ 64 , 65 , 66 , 67 , 68 , 69 ]. The influence of gut microbiota on host health and physiology and more specifically its role in regulating the dysfunction, as reaction to different injuries, of distant organs and systems has been the subject of numerous studies [ 70 ]. A fundamental feature of endothelium function is the mediated nitric-oxide vasodilatation that diet and possibly the gut microbiota could modulate.…”