[Gut microbiota dysbiosis in type 1 diabetes mellitus: Impacts, mechanisms, and interventions]

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease whose pathogenesis involves interactions between genetic susceptibility and environmental factors. Gut microbiota dysbiosis may participate in the onset and progression of T1DM. Dysbiosis of the gut microbiota in patients with T1DM is characterized not only by reduced microbial diversity but also by systemic functional disturbances, particularly the depletion of protective metabolites such as short-chain fatty acids (SCFAs) and secondary bile acids. These alterations may aggravate pancreatic islet autoimmunity through mechanisms including molecular mimicry, disruption of immune homeostasis, and impairment of intestinal barrier function. Intervention strategies targeting the gut microbiota, such as fecal microbiota transplantation, probiotics, and dietary regulation, have shown potential in delaying disease progression and improving glycemic control in animal models and some clinical trials. However, the heterogeneity of therapeutic efficacy still requires further validation. Future studies should integrate multi-omics technologies with personalized medicine approaches to further elucidate microbiota-host interaction mechanisms, thereby promoting early prediction and precision intervention for T1DM. Regulation of the gut microbiota may become a novel therapeutic target for the prevention and treatment of T1DM and provide new strategies for its management.