Microbiome Changes after Type 2 Diabetes Treatment: A Systematic Review.

Area of Science:

• Microbiology
• Endocrinology
• Gastroenterology

Background:

• The gut microbiome's role in type 2 diabetes (T2D) pathophysiology is established.
• Existing reviews often overlook microbiome changes, focusing primarily on metabolic outcomes of T2D treatments.
• Understanding microbiome shifts is crucial for comprehensive T2D management.

Purpose of the Study:

• To systematically evaluate changes in the gut microbiome and metabolic parameters following various T2D treatments.
• To analyze alterations in bacterial composition, diversity, and their correlation with glycemic control.
• To compare the impact of conventional and alternative glucose-lowering therapies on the T2D microbiome.

Main Methods:

• Systematic literature search of major electronic databases (PubMed, Wiley, Science Direct, Cochrane).
• Inclusion of randomized controlled trials from the last five years involving T2D patients.
• Analysis focused on studies reporting gut microbiome composition and metabolic outcomes pre- and post-intervention.

Main Results:

• Sixteen studies with 1301 participants were reviewed, examining oral glucose-lowering drugs, bariatric surgery, and probiotics/prebiotics/synbiotics.
• Common findings included increased Firmicutes and Proteobacteria abundance, correlating with improved glycemic control.
• Bariatric surgery, especially Roux-en-Y gastric bypass, induced the most diverse phyla changes; lower microbial diversity was linked to better glycemic control.

Conclusions:

• Anti-diabetic interventions can restore depleted bacteria and, in some cases, achieve a gut microbiome resembling that of healthy individuals.
• Further research is needed to identify optimal strategies for promoting beneficial bacteria and reducing diversity to achieve a non-T2D microbiome.
• Targeting the gut microbiome represents a promising avenue for novel T2D therapeutic approaches.