A P4 Medicine Perspective of Gut Microbiota and Prediabetes: Systems Analysis and Personalized Intervention

Type 2 diabetes (T2D) accounts for approximately 90% of diabetes worldwide and has become a global public health problem. Generally, individuals go to hospitals and get healthcare only when they have obvious T2D symptoms. While the underlying cause and mechanism of the disease are usually not well understood, treatment is for the symptoms, but not for the disease cause, and patients often continue to progress with more symptoms. Prediabetes is the early stage of diabetes and provides a good time window for intervention and prevention. However, with few symptoms, prediabetes is usually ignored without any treatment. Obviously, it is far from ideal to rely on the traditional medical system for diabetes healthcare. As a result, the medical system must be transformed from a reactive approach to a proactive approach. Root cause analysis and personalized intervention should be conducted for patients with prediabetes. Based on systems medicine, also known as P4 medicine, with a predictive, preventive, personalized, and participatory approach, new medical system is expected to significantly promote the prevention and treatment of chronic diseases such as prediabetes and diabetes. Many studies have shown that the occurrence and development of diabetes is closely related to gut microbiota. However, the relationship between diabetes and gut microbiota has not been fully elucidated. This review describes the research on the relationship between gut microbiota and diabetes and some exploratory trials on the interventions of prediabetes based on P4 medicine model. Furthermore, we also discussed how these findings might influence the diagnosis, prevention and treatment of diabetes in the future, thereby to improve the wellness of human beings.