Hydrogen sulfide to modulate Glycated hemoglobin and gut microbiome in type 2 diabetes mellitus

Hydrogen sulfide (H₂S) is a gasotransmitter implicated in carbohydrate metabolism. This study explored associations between circulating H₂S, glucose homeostasis, and gut microbiome composition in type 2 diabetes mellitus (DM).

Blood H₂S levels were quantified by HPLC in 93 DM patients; insulin resistance was assessed using HOMA-IR. Gut microbiota from 38 patients were analyzed via Oxford Nanopore 16S rRNA sequencing. Analyses were stratified by median H₂S and HbA1c values.

Median H₂S and HbA1c levels were 22.65 μM and 7 %, respectively. Patients with H₂S ≥ 22.65 μM were more likely to have HbA1c ≥ 7 % (OR: 2.75; 95 % CI: 1.18-6.38; p = 0.022). Higher H₂S was linked to lower gut microbial diversity (Shannon index: 3.36 vs. 3.67, p = 0.021; Simpson index: 0.89 vs. 0.93, p = 0.007). Low H₂S was associated with higher relative abundance of Actinomycetota (p = 0.022). No microbiome differences were observed when stratified by HbA1c, and diabetes therapy was not linked to microbial diversity.

Increased blood H₂S correlated with higher HbA1c and reduced microbial diversity, including decreased Actinomycetota. H₂S may represent a potential marker of poor glycemic control and gut microbiota alteration in DM.