Modulating the Gut Microbiome in Type 2 Diabetes: Nutritional and Therapeutic Strategies

Area of Science:

• Microbiology
• Endocrinology
• Metabolic Disorders

Background:

• Type 2 diabetes mellitus (T2DM) is linked to gut dysbiosis, affecting gut barrier function, metabolites, and inflammation.
• This dysbiosis can worsen insulin resistance and beta-cell dysfunction, key factors in T2DM pathogenesis.

Purpose of the Study:

• To review current knowledge on gut microbiota mechanisms in T2DM.
• To evaluate emerging microbiota-targeted therapies as adjunctive strategies for metabolic improvement.

Main Methods:

• Narrative review of studies from PubMed, Scopus, and Google Scholar up to November 2025.
• Included in vitro, animal, and human studies, focusing on intervention trials and mechanistic research.

Main Results:

• Positive signals from randomized controlled trials exist for nutritional interventions (probiotics, prebiotics, etc.).
• Evidence suggests beneficial effects on fasting glucose, HbA1c, and inflammatory markers, but heterogeneity limits definitive conclusions.
• Insufficient evidence currently supports microbiota modulation as a standard T2DM therapy.

Conclusions:

• Gut microbiota modulation shows potential as an adjunctive strategy for T2DM management.
• Key knowledge gaps include standardized interventions, stratified analyses, meaningful endpoints, and long-term safety data.