Acta Scientific Microbiology

Review Article Volume 9 Issue 2

Interactions Between Gut Microbiota and Host Metabolism in Type 2 Diabetes: Pathophysiology and Treatment Prospects

Anita Tilwari, Ruchi Chandsurya and Rohit Saluja

1Department of Microbiology, Barkatullah University, Bhopal, M.P. 462026, India
2Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana 508126, India

*Corresponding Author:Anita Tilwari (anitatilwari@bubhopal.ac.in), Department of Microbiology, Barkatullah University, Bhopal, M.P. 462026, India

Received: January 19, 2026; Published: January 31, 2026

Abstract

The human colon is home to a diverse community of microorganisms collectively known as the gut microbiota. These microorgan- isms play an essential, though indirect, role in maintaining human health by supporting various physiological functions. The primary roles of the gut microbiota include reducing gut permeability, increasing the production of short-chain fatty acids, decreasing inflam- mation, and repairing leaky gut barriers. These microbes also produce several metabolites such as bile acids, butyric acid, branched- chain amino acids, trimethylamine-N-oxide, lipopolysaccharides, and short-chain fatty acids that influence the gut environment and can contribute to dysbiosis. This review explores the composition of the gut microbiota in healthy individuals compared to those with Type 2 Diabetes, with a particular focus on microbial metabolic activity that affects insulin sensitivity and resistance. It also examines diabetes-related physiological and pathological factors, including the effects of age, physical activity, obesity, diet, and antibiotic use, supported by clinical data. Furthermore, the review discusses various therapeutic approaches with promising potential for diabetes reversal. Overall, this work aims to provide valuable insights into gut dysbiosis and microbiota, contributing to future translational research.

Keywords: Type 2 Diabetes; Gut Microbiota; Metabolites; Insulin Sensitivity; Dysbiosis

References

  1. World Health Organization. “World health statistics 2014”. Geneva: World Health Organization (2014). 177.
  2. Sun H., et al. “IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045”. Diabetes Research and Clinical Practice 183 (2022): 109119.
  3. Tremaroli V and Bäckhed F. “Functional interactions between the gut microbiota and host metabolism”. Nature 7415 (2012): 242-249.
  4. Delzenne NM and Cani PD. “Interaction Between Obesity and the Gut Microbiota: Relevance in Nutrition”. Annual Reviews on Nutrition1 (2011): 15-31.
  5. Suzuki T., et al. “Physiological concentrations of short-chain fatty acids immediately suppress colonic epithelial permeability”. British Journal of Nutrition2 (2008): 297-305.
  6. Cani PD., et al. “Glucose metabolism: Focus on gut microbiota, the endocannabinoid system and beyond”. Diabetes Metabolism 4 (2014): 246-257.
  7. Zheng H., et al. “Depletion of acetate-producing bacteria from the gut microbiota facilitates cognitive impairment through the gut-brain neural mechanism in diabetic mice”. Microbiome 9 (2021): 145.
  8. Iatcu CO., et al. “Gut Microbiota and Complications of Type-2 Diabetes”. Nutrients 1 (2022): 166.
  9. Wu J., et al. “Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus”. Frontiers in Endocrinology 14 (2023).
  10. Markowiak-Kopeć P and Śliżewska K. “The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome”. Nutrients 4 (2020): 1107.
  11. Kim YA., et al. “Probiotics, prebiotics, symbiotic and insulin sensitivity”. Nutrition Research Reviews1 (2018): 35-51.
  12. Keitel V and Häussinger D. “Role of TGR5 (GPBAR1) in Liver Disease”. Seminar on Liver Disease 38 (2018): 333-339.
  13. Jiang Z., et al. “Dietary fruit and vegetable intake, gut microbiota, and type 2 diabetes: results from two large human cohort studies”. BMC Medicine 18 (2020): 371.
  14. Islam KBMS., et al. “Bile Acid Is a Host Factor That Regulates the Composition of the Cecal Microbiota in Rats”. Gastroenterology 5 (2011): 1773-1781.
  15. Ma XM., et al. “Molecular mechanisms of mTOR-mediated translational control”. Nature Reviews Molecular Cell Biology 10 (2021): 307-318.
  16. Cota D., et al. “Hypothalamic mTOR Signaling Regulates Food Intake”. Science5775 (2006): 927-930.
  17. Zoncu R., et al. “mTOR: from growth signal integration to cancer, diabetes and ageing”. Nature Reviews Molecular Cell Biology1 (2011): 21-35.
  18. Yoon MS. “The Emerging Role of Branched-Chain Amino Acids in Insulin Resistance and Metabolism”. Nutrients 7 (2016): 405.
  19. Weickert MO., et al. “Effects of supplemented isoenergetic diets differing in cereal fiber and protein content on insulin sensitivity in overweight humans 123”. American Journal of Clinical Nutrition2 (2011): 459-471.
  20. Rajpal A., et al. “Effects of transaldolase exchange on estimates of gluconeogenesis in type 2 diabetes”. American Journal of Physiology-Endocrinology and Metabolism4 (2013): E465-474.
  21. Schönfeld P and Wojtczak L. “Short- and medium-chain fatty acids in energy metabolism: the cellular perspective”. Journal of Lipid Research6 (2016): 943-954.
  22. Koh A., et al. “From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites”. Cell6 (2016): 1332-1345.
  23. Chauhan V., et al. “Comparative in-silico analysis of microbial dysbiosis discern potential metabolic link in neurodegenerative diseases”. Frontiers in Neuroscience 17 (2023): 1153422.
  24. Du Y., et al. “The Role of Short Chain Fatty Acids in Inflammation and Body Health”. International Journal of Molecular Science 13 (2024): 7379.
  25. Manson JM., et al. “The Commensal Microbiology of the Gastrointestinal Tract”. In: Huffnagle GB, Noverr MC, editors. GI Microbiota and Regulation of the Immune System. New York, NY: Springer New York (2008): 15-28. (Advances in Experimental Medicine and Biology; vol. 635).
  26. Ofosu FK., et al. “Fermented sorghum improves type 2 diabetes remission by modulating gut microbiota and their related metabolites in high fat diet-streptozotocin induced diabetic mice”. Journal of Functional Foods 107 (2023): 105666.
  27. Wilson Tang WH., et al. “Intestinal Microbiota-Dependent Phosphatidylcholine Metabolites, Diastolic Dysfunction and Adverse Clinical Outcomes in Chronic Systolic Heart Failure”. Journal of Cardiac Failure2 (2015): 91-96.
  28. Shih DM., et al. “Flavin containing monooxygenase 3 exerts broad effects on glucose and lipid metabolism and atherosclerosis”. Journal of Lipid Research1 (2015): 22-37.
  29. Longo S., et al. “Microbiota-gut-brain axis: relationships among the vagus nerve, gut microbiota, obesity, and diabetes”. Acta Diabetology 60 (8 (2023): 1007-1017.
  30. Miao J., et al. “Flavin-containing monooxygenase 3 as a potential player in diabetes-associated atherosclerosis”. Nature Communication 6 (2015): 6498.
  31. Gutsmann T., et al. “Structural prerequisites for endotoxic activity in the Limulus test as compared to cytokine production in mononuclear cells”. Innate Immunology1 (2010): 39-47.
  32. Gao X., et al. “Fish oil ameliorates trimethylamine N-oxide-exacerbated glucose intolerance in high-fat diet-fed mice”. Food Function4 (2015): 1117-1125.
  33. Nawrot M., et al. “Intestine-liver crosstalk in Type 2 Diabetes and non-alcoholic fatty liver disease”. Metabolism 123 (2021): 154844.
  34. Sanz Y and Moya-Pérez A. “Microbiota, Inflammation and Obesity”. In: Lyte M, Cryan JF, editors. Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease. New York, NY: Springer (2014): 291-317.
  35. Brun P., et al. “Increased intestinal permeability in obese mice: new evidence in the pathogenesis of nonalcoholic steatohepatitis”. American Journal of Physiology-Gastrointestinal and Liver Physiology2 (2007): G518-25.
  36. Chen R., et al. “Gut microbiota diversity in middle-aged and elderly patients with end-stage diabetic kidney disease”. Annals of Translation Medicine 10 (13 (2022): 750.
  37. Pushpanathan P., et al. “Gut microbiota and its mysteries”. Indian Journal of Medical Microbiology2 (2019): 268-277.
  38. Misra A., et al. “High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat”. International Journal of Obesity10 (2004): 1217-1226.
  39. Sumi S and Kartha CC. “Genetic and Epigenetic Regulation by Gut Microbe-Modulated Metabolites in Chronic Metabolic Diseases”. In: Thomas S, editor. Human Microbiome  : Clinical Implications and Therapeutic Interventions. Singapore: Springer Nature (2022): 109-1
  40. Silamiķele L., et al. “Metformin Strongly Affects Gut Microbiome Composition in High-Fat Diet-Induced Type 2 Diabetes Mouse Model of Both Sexes”. Frontiers in Endocrinology 12 (2011): 626359.
  41. Karmakar B and Roy S. “Traditional and Unconventional Food Crops with the Potential to Boost Health and Nutrition with Special Reference to Asian and African Countries”. In: Roy S, Nisha P, Chakraborty R, editors. Traditional Foods: The Reinvented Superfoods. Cham: Springer Nature Switzerland; (2024): 45-67.
  42. Wen L and Duffy A. “Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes”. Journal of Nutrition7 (2017): 1468S-1475S.
  43. Sachdev M and Misra A. “Heterogeneity of Dietary practices in India: current status and implications for the prevention and control of type 2 diabetes”. European Journal of Clinical Nutrition 77 (2 (2023): 145-155.
  44. Korpela K and de Vos WM. “Early life colonization of the human gut: microbes matter everywhere”. Current Opinion on Microbiology 44 (2018): 70-78.
  45. Brismar B., et al. “Comparative effects of clarithromycin and erythromycin on the normal intestinal microflora”. Scandinavian Journal of Infectious Diseases5 (1991): 635-642.
  46. Reyman M., et al. “Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial”. Nature Communication 13 (1 (2022): 893.
  47. Bauer PV., et al. “Metformin Alters Upper Small Intestinal Microbiota that Impact a Glucose-SGLT1-Sensing Glucoregulatory Pathway”. Cell Metabolism 27 (1 (2018): 101-117.e5.
  48. Horakova O., et al. “Metformin acutely lowers blood glucose levels by inhibition of intestinal glucose transport”. Scientific Report 9 (1 (2019): 6156.
  49. Alvarez-Silva C., et al. “Trans-ethnic gut microbiota signatures of type 2 diabetes in Denmark and India. Genome Medicine1 (2021): 37.
  50. Ding D., et al. “Prospective Study Reveals Host Microbial Determinants of Clinical Response to Fecal Microbiota Transplant Therapy in Type 2 Diabetes Patients”. Frontiers in Cellular and Infection Microbiology 12 (2022): 820367.
  51. Jiang H., et al. “Synbiotics and Gut Microbiota: New Perspectives in the Treatment of Type 2 Diabetes Mellitus”. Foods Basel Switz16 (2022): 2438.
  52. Campos GM., et al. “Lactococcus lactis as an Interleukin Delivery System for Prophylaxis and Treatment of Inflammatory and Autoimmune Diseases”. Probiotics Antimicrobe Proteins (2023): 1-15.
  53. Bober JR., et al. “Synthetic Biology Approaches to Engineer Probiotics and Members of the Human Microbiota for Biomedical Applications”. Annual Review of Biomedical Engineering 20 (2018): 277-300.
  54. Tavanti M. “Synthetic DNA Libraries for Protein Engineering Toward Process Improvement in Drug Synthesis”. Methods in Molecular Biology 2397 (2022): 33-45.
  55. Wang X hua., et al. “Fasting serum total bile acid levels are associated with insulin sensitivity, islet β-cell function and glucagon levels in response to glucose challenge in patients with type 2 diabetes”. Endocrine Journal11 (2020): 1107-1117.
  56. Liu Y., et al. “Genetically engineered bacterium: Principles, practices, and prospects”. Frontiers in Microbiology 13 (2022): 997587.
  57. Liu KF., et al. “Oral administration of Lactococcus lactis-expressing heat shock protein 65 and tandemly repeated IA2P2 prevents type 1 diabetes in NOD mice”. Immunology Letter 174 (2016): 28-36.
  58. Hu H., et al. “Improvement effect of a next-generation probiotic L. plantarum-pMG36e-GLP-1 on type 2 diabetes mellitus via the gut-pancreas-liver axis”. Food Function7 (2023): 3179-3195.
  59. Peters JM., et al. “Enabling genetic analysis of diverse bacteria with Mobile-CRISPRi”. Nature Microbiology2 (2019): 244-250.

Citation

Citation: Anita Tilwari., et al. “Interactions Between Gut Microbiota and Host Metabolism in Type 2 Diabetes: Pathophysiology and Treatment Prospects". Acta Scientific Microbiology 9.2 (2026): 47-62.

Copyright

Copyright: © 2026 Anita Tilwari., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days

Indexed In






News and Events


  • Publication Certificate
    Authors will be provided with the Publication Certificate after their successful publication
  • Last Date for submission
    Authors are requested to submit manuscripts on/before February 19, 2026, for the upcoming issue of 2026.

Contact US