Unveiling the gut connection: Exploring the link between microbiota and type 1 diabetes onset in pediatric patients

With the increasing occurrence of type 1 diabetes mellitus (T1DM) in younger individuals, it is important to identifying contributing factors. A retrospective case control pilot study involving 31 children within the first 6 months after diagnosis, was conducted in the Elias Hospital in Bucharest, Romania) between January 2019- December 2021. Spearman correlation analysis was performed, evaluating the association between microbiota and early onset T1DM, high-level onset glycaemia, ketoacidosis, thyroid autoimmunity and clinical parameters involving growth. Gut dysbiosis with an overabundance of bacteria and fungi was observed compared with the healthy control group. Butyricicoccus was positively associated with younger age at onset (r=0.6276, P=0.0018) but negatively correlated with markers of disease progression, such as T1DM recent diagnosis (r=-0.517, P=0.0164), homeostasis model assessment of β-cell function) (r=-0.5962, P=0.0034) and C-peptide values (r=-0.5005, P=0.0344). Bacteroides showed a negative association with early-stage diabetes (r=-0.4431, P=0.0442) and Clostridium leptum was negatively associated with recent diagnosis (r=-0.6278, P=0.0023). Antibiotic use prior to disease diagnosis was positively correlated with Candida albicans (r=0.4431, P=0.0442). Inflammation, determined by the systemic inflammatory index, was positively correlated with Enterobacteriaceae (r=0.4331, P=0.0441) and negatively correlated with Clostridium coccoides (r=-0.4241, P=0.0492). C-reactive protein levels were negatively associated with Bacteroides (r=-0.4331, P=0.0498). These findings highlighted the role of gut microbiota in pancreatic inflammation and T1DM progression. In conclusion, dysbiosis of children with T1DM was correlated with younger age and a more severe onset. Microbial metabolites levels differed in these patients compared with the healthy control group. To the best of our knowledge, the present study is the first to assess gastrointestinal dysbiosis in T1DM.