Author(s):
Waghamare Suresh, Shreyash Salpure, Mansi Nikam
Email(s):
waghasuresh@gmail.com
DOI:
10.52711/2321-5836.2025.00046
Address:
Waghamare Suresh1*, Shreyash Salpure2, Mansi Nikam3
1Department of Pharmaceutics at NIMS Institute of Pharmacy, NIMS University, Jaipur, Rajasthan, India - 302131.
2,3 Rashtriya College of Pharmacy, Hatnoor, Kannad, Maharashtra, India - 431103.
*Corresponding Author
Published In:
Volume - 17,
Issue - 4,
Year - 2025
ABSTRACT:
This review examines the vital role of the gut microbiome in maintaining metabolic balance and its involvement in the development and progression of both Type 1 and Type 2 diabetes (T1D and T2D). It aims to clarify the connections between microbial composition, diversity, and function, and how these factors influence diabetic pathophysiology. An analysis of recent literature was performed, focusing on studies that explore gut microbial changes in diabetic patients, mechanisms of microbiome-related metabolic shifts, and therapeutic strategies. Emphasis was placed on interventions such as probiotics, prebiotics, fecal microbiota transplantation (FMT), and dietary changes. The results show that dysbiosis, an imbalance in gut microbial communities, is common in both T1D and T2D. Dysbiosis promotes disease development by encouraging inflammation, weakening gut barrier function, and causing insulin resistance. Several microbiome-modulating therapies have shown potential in enhancing blood sugar control and metabolic health. However, individual responses vary greatly due to personal microbial and genetic differences. The gut microbiome plays a key role in the development and treatment of diabetes. While microbiome-based therapies are promising, their clinical use remains difficult. Future efforts should focus on personalized approaches that take into account individual microbiome profiles to improve therapeutic success.
Cite this article:
Waghamare Suresh, Shreyash Salpure, Mansi Nikam. The Gut Microbiome and Diabetes: A Review of Current Understanding and Therapeutic Implications. Research Journal of Pharmacology and Pharmacodynamics. 2025;17(4):295-3. doi: 10.52711/2321-5836.2025.00046
Cite(Electronic):
Waghamare Suresh, Shreyash Salpure, Mansi Nikam. The Gut Microbiome and Diabetes: A Review of Current Understanding and Therapeutic Implications. Research Journal of Pharmacology and Pharmacodynamics. 2025;17(4):295-3. doi: 10.52711/2321-5836.2025.00046 Available on: https://rjppd.org/AbstractView.aspx?PID=2025-17-4-8
REFERENCE:
1. Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. Eur J Prev Cardiolog [Internet]. 2019 Dec [cited 2025 May 22];26(2_suppl):7–14. Available from: https://academic.oup.com/eurjpc/article/26/2_suppl/7-14/5925429
2. Miller TD, Redberg RF, Wackers FJT. Screening Asymptomatic Diabetic Patients for Coronary Artery Disease. Journal of the American College of Cardiology [Internet]. 2006 Aug [cited 2025 May 22]; 48(4): 761–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0735109706013301
3. Patel N, Ravindra HN. Impact of Health Education Programme on knowledge regarding prevention of complications of diabetic mellitus among diabetes veterans at selected old age home of Baroda. Asia Jour Nurs Educ and Rese [Internet]. 2015 [cited 2025 Aug 1]; 5(3): 405. Available from: http://www.indianjournals.com/ijor.aspx?target=ijor:ajner&volume=5&issue=3&article=020
4. Al-Nozha MM, Ismail HM, Al Nozha OM. Coronary artery disease and diabetes mellitus. Journal of Taibah University Medical Sciences [Internet]. 2016 Aug [cited 2025 May 22]; 11(4): 330–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1658361216300117
5. Jacoby RM, Nesto RW. Acute myocardial infarction in the diabetic patient: Pathophysiology, clinical course and prognosis. Journal of the American College of Cardiology [Internet]. 1992 Sep [cited 2025 May 22]; 20(3): 736–44. Available from: https://linkinghub.elsevier.com/retrieve/pii/073510979290033J
6. Allaqaband H, Gutterman DD, Kadlec AO. Physiological Consequences of Coronary Arteriolar Dysfunction and Its Influence on Cardiovascular Disease. Physiology [Internet]. 2018 Sep 1 [cited 2025 May 22]; 33(5): 338–47. Available from: https://www.physiology.org/doi/10.1152/physiol.00019.2018
7. Makker J, Sun H, Patel H, Mantri N, Zahid M, Gongati S, et al. Impact of Prediabetes and Type-2 Diabetes on Outcomes in Patients with COVID-19. Pintaudi B, editor. International Journal of Endocrinology [Internet]. 2021 Jun 16 [cited 2025 May 22]; 2021: 1–9. Available from: https://www.hindawi.com/journals/ije/2021/5516192/
8. Aziz T, Hussain N, Hameed Z, Lin L. Elucidating the role of diet in maintaining gut health to reduce the risk of obesity, cardiovascular and other age-related inflammatory diseases: recent challenges and future recommendations. Gut Microbes [Internet]. 2024 Dec 31 [cited 2025 May 22]; 16(1): 2297864. Available from: https://www.tandfonline.com/doi/full/10.1080/19490976.2023.2297864
9. Hou K, Wu ZX, Chen XY, Wang JQ, Zhang D, Xiao C, et al. Microbiota in health and diseases. Signal Transduction and Targeted Therapy [Internet]. 2022 Apr 23;7(1):135. Available from: https://doi.org/10.1038/s41392-022-00974-4
10. Zhang P. Influence of Foods and Nutrition on the Gut Microbiome and Implications for Intestinal Health. IJMS [Internet]. 2022 Aug 24 [cited 2025 May 23];23(17):9588. Available from: https://www.mdpi.com/1422-0067/23/17/9588
11. Gurung M, Li Z, You H, Rodrigues R, Jump DB, Morgun A, et al. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine [Internet]. 2020 Jan [cited 2025 May 23]; 51:102590. Available from: https://linkinghub.elsevier.com/retrieve/pii/S235239641930800X
12. Craciun CI, Neag MA, Catinean A, Mitre AO, Rusu A, Bala C, et al. The Relationships between Gut Microbiota and Diabetes Mellitus, and Treatments for Diabetes Mellitus. Biomedicines [Internet]. 2022 Jan 28 [cited 2025 May 22];10(2):308. Available from: https://www.mdpi.com/2227-9059/10/2/308
13. Leonard JM, Toro DD. Defining the Microbiome Components (Bacteria, Viruses, Fungi) and Microbiome Geodiversity. Surgical Infections [Internet]. 2023 Apr 1 [cited 2025 May 22];24(3):208–12. Available from: https://www.liebertpub.com/doi/10.1089/sur.2023.014
14. Sadagopan A, Mahmoud A, Begg M, Tarhuni M, Fotso M, Gonzalez NA, et al. Understanding the Role of the Gut Microbiome in Diabetes and Therapeutics Targeting Leaky Gut: A Systematic Review. Cureus [Internet]. 2023 Jul 8 [cited 2025 May 22]; Available from: https://www.cureus.com/articles/162523-understanding-the-role-of-the-gut-microbiome-in-diabetes-and-therapeutics-targeting-leaky-gut-a-systematic-review
15. Rinninella E, Raoul P, Cintoni M, Franceschi F, Miggiano GAD, Gasbarrini A, et al. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms [Internet]. 2019 Jan 10 [cited 2025 May 22];7(1):14. Available from: https://www.mdpi.com/2076-2607/7/1/14
16. Hou K, Wu ZX, Chen XY, Wang JQ, Zhang D, Xiao C, et al. Microbiota in health and diseases. Sig Transduct Target Ther [Internet]. 2022 Apr 23 [cited 2025 May 23];7(1). Available from: https://www.nature.com/articles/s41392-022-00974-4
17. Verma J, Anwar MT, Linz B, Backert S, Pachathundikandi SK. The Influence of Gastric Microbiota and Probiotics in Helicobacter pylori Infection and Associated Diseases. Biomedicines [Internet]. 2024 Dec 30 [cited 2025 May 22];13(1):61. Available from: https://www.mdpi.com/2227-9059/13/1/61
18. Rowland I, Gibson G, Heinken A, Scott K, Swann J, Thiele I, et al. Gut microbiota functions: metabolism of nutrients and other food components. Eur J Nutr [Internet]. 2018 Feb [cited 2025 May 23]; 57(1): 1–24. Available from: http://link.springer.com/10.1007/s00394-017-1445-8
19. Pieren DKJ, Boer MC, De Wit J. The adaptive immune system in early life: The shift makes it count. Front Immunol [Internet]. 2022 Nov 17 [cited 2025 May 23]; 13. Available from: https://www.frontiersin.org/articles/10.3389/fimmu.2022.1031924/full
20. Verster AJ, Salerno P, Valls R, Barrack K, Price CE, McClure EA, et al. Persistent delay in maturation of the developing gut microbiota in infants with cystic fibrosis. Whiteley M, Brown S, editors. mBio [Internet]. 2025 Mar 12 [cited 2025 May 23];16(3). Available from: https://journals.asm.org/doi/10.1128/mbio.03420-24
21. Cryan JF, Dinan TG. Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci [Internet]. 2012 Oct [cited 2025 May 23];13(10):701–12. Available from: https://www.nature.com/articles/nrn3346
22. Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microbial Ecology in Health & Disease [Internet]. 2015 Feb 2 [cited 2025 May 23];26(0). Available from: http://www.microbecolhealthdis.net/index.php/mehd/article/view/26191
23. Makki K, Deehan EC, Walter J, Bäckhed F. The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease. Cell Host & Microbe [Internet]. 2018 Jun [cited 2025 May 23];23(6):705–15. Available from: https://linkinghub.elsevier.com/retrieve/pii/S193131281830266X
24. Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med [Internet]. 2016 Dec [cited 2025 May 23];8(1). Available from: https://genomemedicine.biomedcentral.com/articles/10.1186/s13073-016-0294-z
25. Belkaid Y, Hand TW. Role of the Microbiota in Immunity and Inflammation. Cell [Internet]. 2014 Mar [cited 2025 May 23];157(1):121–41. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0092867414003456
26. MetaHIT Consortium, Qin J, Li R, Raes J, Arumugam M, Burgdorf KS, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature [Internet]. 2010 Mar [cited 2025 May 23];464(7285):59–65. Available from: https://www.nature.com/articles/nature08821
27. Flint HJ, Scott KP, Duncan SH, Louis P, Forano E. Microbial degradation of complex carbohydrates in the gut. Gut Microbes [Internet]. 2012 Jul 14 [cited 2025 May 23];3(4):289–306. Available from: https://www.tandfonline.com/doi/full/10.4161/gmic.19897
28. Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S. Gut Microbiota’s Effect on Mental Health: The Gut-Brain Axis. Clinics and Practice [Internet]. 2017 Sep 15 [cited 2025 May 23];7(4):987. Available from: https://www.mdpi.com/2039-7283/7/4/987
29. Petersen C, Round JL. Defining dysbiosis and its influence on host immunity and disease. Cell Microbiol [Internet]. 2014 Jul [cited 2025 May 23];16(7):1024–33. Available from: https://onlinelibrary.wiley.com/doi/10.1111/cmi.12308
30. Bailey MT, Dowd SE, Galley JD, Hufnagle AR, Allen RG, Lyte M. Exposure to a social stressor alters the structure of the intestinal microbiota: Implications for stressor-induced immunomodulation. Brain, Behavior, and Immunity [Internet]. 2011 Mar [cited 2025 May 23];25(3):397–407. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0889159110005295
31. Ouwehand AC, Salminen S, Isolauri E. Probiotics: an overview of beneficial effects. Antonie Van Leeuwenhoek [Internet]. 2002 Aug [cited 2025 May 23];82(1–4):279–89. Available from: https://link.springer.com/10.1023/A:1020620607611
32. Gülden E, Wong FS, Wen L. The gut microbiota and Type 1 Diabetes. Clinical Immunology [Internet]. 2015 Aug [cited 2025 May 23];159(2):143–53. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1521661615001989
33. Radhika CK, Raj A. Uremic Hypoglycemia. Asia Jour Nurs Educ and Rese [Internet]. 2017 [cited 2025 Aug 1];7(3):445. Available from: http://www.indianjournals.com/ijor.aspx?target=ijor:ajner&volume=7&issue=3&article=034
34. Mazziotta C, Tognon M, Martini F, Torreggiani E, Rotondo JC. Probiotics Mechanism of Action on Immune Cells and Beneficial Effects on Human Health. Cells [Internet]. 2023 Jan 2 [cited 2025 May 23];12(1):184. Available from: https://www.mdpi.com/2073-4409/12/1/184
35. Siljander H, Honkanen J, Knip M. Microbiome and type 1 diabetes. eBioMedicine [Internet]. 2019 Aug [cited 2025 May 23];46:512–21. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2352396419304128
36. Leiva-Gea I, Sánchez-Alcoholado L, Martín-Tejedor B, Castellano-Castillo D, Moreno-Indias I, Urda-Cardona A, et al. Gut Microbiota Differs in Composition and Functionality Between Children With Type 1 Diabetes and MODY2 and Healthy Control Subjects: A Case-Control Study. Diabetes Care [Internet]. 2018 Nov 1 [cited 2025 May 23];41(11):2385–95. Available from: https://diabetesjournals.org/care/article/41/11/2385/36608/Gut-Microbiota-Differs-in-Composition-and
37. Rathod S. Novel Insights into the Immunotherapy-Based Treatment Strategy for Autoimmune Type 1 Diabetes. Diabetology [Internet]. 2022 Feb 7 [cited 2025 May 23];3(1):79–96. Available from: https://www.mdpi.com/2673-4540/3/1/7
38. Addissouky TA, Ali MMA, El Sayed IET, Wang Y. Type 1 diabetes mellitus: retrospect and prospect. Bull Natl Res Cent [Internet]. 2024 Apr 19 [cited 2025 May 23];48(1). Available from: https://BNRC.springeropen.com/articles/10.1186/s42269-024-01197-z
39. Ye J, Wu Z, Zhao Y, Zhang S, Liu W, Su Y. Role of gut microbiota in the pathogenesis and treatment of diabetes mullites: Advanced research-based review. Front Microbiol [Internet]. 2022 Oct 19 [cited 2025 Aug 20]; 13:1029890. Available from: https://www.frontiersin.org/articles/10.3389/fmicb.2022.1029890/full
40. Vatanen T, Franzosa EA, Schwager R, Tripathi S, Arthur TD, Vehik K, et al. The human gut microbiome in early-onset type 1 diabetes from the TEDDY study. Nature [Internet]. 2018 Oct [cited 2025 Aug 20];562(7728):589–94. Available from: https://www.nature.com/articles/s41586-018-0620-2
41. Xie C, Qi C, Zhang J, Wang W, Meng X, Aikepaer A, et al. When short-chain fatty acids meet type 2 diabetes mellitus: Revealing mechanisms, envisioning therapies. Biochemical Pharmacology [Internet]. 2025 Mar [cited 2025 May 23]; 233:116791. Available from: https://linkinghub.elsevier.com/retrieve/pii/S000629522500053X
42. Ghosh SS, Wang J, Yannie PJ, Ghosh S. Intestinal Barrier Dysfunction, LPS Translocation, and Disease Development. Journal of the Endocrine Society [Internet]. 2020 Feb 1 [cited 2025 May 23];4(2). Available from: https://academic.oup.com/jes/article/doi/10.1210/jendso/bvz039/5741771
43. Dimba NR, Mzimela N, Khathi A. Improved Gut Health May Be a Potential Therapeutic Approach for Managing Prediabetes: A Literature Review. Biomedicines [Internet]. 2024 Jun 8 [cited 2025 May 23];12(6):1275. Available from: https://www.mdpi.com/2227-9059/12/6/1275
44. Zhang S, Cai Y, Meng C, Ding X, Huang J, Luo X, et al. The role of the microbiome in diabetes mellitus. Diabetes Research and Clinical Practice [Internet]. 2021 Feb [cited 2025 May 23]; 172:108645. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0168822720309025
45. Davani-Davari D, Negahdaripour M, Karimzadeh I, Seifan M, Mohkam M, Masoumi S, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods [Internet]. 2019 Mar 9 [cited 2025 May 23];8(3):92. Available from: https://www.mdpi.com/2304-8158/8/3/92
46. Aziz T, Hussain N, Hameed Z, Lin L. Elucidating the role of diet in maintaining gut health to reduce the risk of obesity, cardiovascular and other age-related inflammatory diseases: recent challenges and future recommendations. Gut Microbes [Internet]. 2024 Dec 31 [cited 2025 May 23];16(1). Available from: https://www.tandfonline.com/doi/full/10.1080/19490976.2023.2297864
47. Gupta S, Allen-Vercoe E, Petrof EO. Fecal microbiota transplantation: in perspective. Therap Adv Gastroenterol [Internet]. 2016 Mar [cited 2025 May 23];9(2):229–39. Available from: https://journals.sagepub.com/doi/10.1177/1756283X15607414
48. Singha B, Rawat BS, Venkataraman R, Nair T, Rosenn EH, Soni V. Gut microbiome associated dysbiosis: Limited regimens and expanding horizons of phage therapy. Aspects of Molecular Medicine [Internet]. 2023 Dec [cited 2025 May 23];2:100029. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2949688823000291
49. Isali I, Helstrom EK, Uzzo N, Lakshmanan A, Nandwana D, Valentine H, et al. Current Trends and Challenges of Microbiome Research in Bladder Cancer. Curr Oncol Rep [Internet]. 2024 Mar [cited 2025 May 23];26(3):292–8. Available from: https://link.springer.com/10.1007/s11912-024-01508-7
50. Ranveer SA, Dasriya V, Ahmad MF, Dhillon HS, Samtiya M, Shama E, et al. Positive and negative aspects of bacteriophages and their immense role in the food chain. npj Sci Food [Internet]. 2024 Jan 3 [cited 2025 May 23];8(1). Available from: https://www.nature.com/articles/s41538-023-00245-8
51. Wu J, Yang K, Fan H, Wei M, Xiong Q. Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus. Front Endocrinol [Internet]. 2023 May 9 [cited 2025 May 23];14. Available from: https://www.frontiersin.org/articles/10.3389/fendo.2023.1114424/full
52. Brittain HK, Scott R, Thomas E. The rise of the genome and personalised medicine. Clinical Medicine [Internet]. 2017 Dec [cited 2025 May 23];17(6):545–51. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1470211824013162
53. Kashyap PC, Chia N, Nelson H, Segal E, Elinav E. Microbiome at the Frontier of Personalized Medicine. Mayo Clinic Proceedings [Internet]. 2017 Dec [cited 2025 May 23];92(12):1855–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0025619617307322
54. Hemmati MA, Monemi M, Asli S, Mohammadi S, Foroozanmehr B, Haghmorad D, et al. Using New Technologies to Analyze Gut Microbiota and Predict Cancer Risk. Cells [Internet]. 2024 Dec 1 [cited 2025 May 23];13(23):1987. Available from: https://www.mdpi.com/2073-4409/13/23/1987
55. Xiang Q, Lott AA, Assmann SM, Chen S. Advances and perspectives in the metabolomics of stomatal movement and the disease triangle. Plant Science [Internet]. 2021 Jan [cited 2025 May 23]; 302:110697. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0168945220303034
56. Lin C, Tian Q, Guo S, Xie D, Cai Y, Wang Z, et al. Metabolomics for Clinical Biomarker Discovery and Therapeutic Target Identification. Molecules [Internet]. 2024 May 8 [cited 2025 May 23];29(10):2198. Available from: https://www.mdpi.com/1420-3049/29/10/2198
57. Cai X, Jin J, Ye H, Xiang X, Luo L, Li J. Altered serum metabolome is associated with disease activity and immune responses in rheumatoid arthritis. Clin Rheumatol [Internet]. 2024 Dec [cited 2025 May 23];43(12):3669–78. Available from: https://link.springer.com/10.1007/s10067-024-07201-1