Relationship between Microbiome Diversity, Metabolic Disorders, and Personalized Treatment Strategies in Diabetes Mellitus

Abstract

Diabetes Mellitus is defined as a chronic metabolic disorder that is caused by an increase in blood glucose concentration due to impaired insulin production, insulin sensitivity or a combination of these. The recent scientific findings underscored that the gut microbiome plays a key regulatory role in balancing the metabolism, and that the bacteria associated with glucose metabolism, insulin sensitivity and inflammation also play a role in systemic inflammation. Dysbiosis, also known as microbial imbalance, has emerged as a notable hallmark of metabolic diseases, notably type 2 diabetes mellitus (T2DM). Changes in the gut microbiota affect host metabolism for various reasons including, but not limited to, production of short-chain fatty acids, immune modulation, intestinal permeability and chronic low-grade inflammation. Further evidence is accumulating that microbiome signatures can serve as a biomarker for early diagnosis and risk stratification for diabetes. Moreover, treatment strategies that are personalized upon the individual, such as the microbiome-directed therapies microbiome-associated probiotics, prebiotics, diet modification and fecal microbiota transplantation, have demonstrated a promising effect on glycemic control and metabolic outcomes. This review investigates the link between the diversity of the microbiome and alterations in metabolism, as well as future prospects for individual-based medicine applications in the context of DM.