Microbiota: A potential orchestrator of antidiabetic therapy

Front Endocrinol (Lausanne). 2023 Jan 27:14:973624. doi: 10.3389/fendo.2023.973624. eCollection 2023.

Abstract

The gut microbiota, as a 'new organ' of humans, has been identified to affect many biological processes, including immunity, inflammatory response, gut-brain neural circuits, and energy metabolism. Profound dysbiosis of the gut microbiome could change the metabolic pattern, aggravate systemic inflammation and insulin resistance, and exacerbate metabolic disturbance and the progression of type 2 diabetes (T2D). The aim of this review is to focus on the potential roles and functional mechanisms of gut microbiota in the antidiabetic therapy. In general, antidiabetic drugs (α-glucosidase inhibitor, biguanides, incretin-based agents, and traditional Chinese medicine) induce the alteration of microbial diversity and composition, and the levels of bacterial component and derived metabolites, such as lipopolysaccharide (LPS), short chain fatty acids (SCFAs), bile acids and indoles. The altered microbial metabolites are involved in the regulation of gut barrier, inflammation response, insulin resistance and glucose homeostasis. Furthermore, we summarize the new strategies for antidiabetic treatment based on microbial regulation, such as pro/prebiotics administration and fecal microbiota transplantation, and discuss the need for more basic and clinical researches to evaluate the feasibility and efficacy of the new therapies for diabetes.

Keywords: antidiabetic therapy; glucoregulatory agents; gut microbiota; metabolites; type 2 diabetes.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Inflammation
  • Insulin Resistance*
  • Microbiota*

Substances

  • Hypoglycemic Agents

Grants and funding

This work was supported by the grants from the National Science Fund for Distinguished Young Scholars of China (No. 81925007), the Natural Science Foundation of Chongqing (No. cstc2021jcyj-msxmX0465), the “Talent Project” of Army Medical University (2019R055), Special Program for Basic Research Frontier of Military Medicine of the Second Affiliated Hospital of Army Medical University (No. 2019YQYLY002 and No. 2018YQYLY006), and the Science Innovation Program Led by Academicians in Chongqing (No. cstc2017jcyj-yszxX0003).