The Gut Microbiota—A Pandora’s Box Having an Effect on Diabetes

The Gut Positively & Negatively Contributes Toward Diabetes

The human microbiome is one of the most-happening topics of discussion among healthcare practitioners, scientists, and even health-conscious people during recent times, especially after various research have clearly proved its effects on human health and obesity risks. The latest fascination that’s caught everyone’s attention is how the gut microbiota’s composition could play a substantial role in contributing toward diabetes.
 
Diabetes is one of the most common metabolic diseases that has a debilitating impact on human health. According to the World Health organization (WHO) and the International Diabetes Federation (IDF), there is a staggering increase in diabetes levels and by 2045, the numbers are expected to go as high as 700 million.
 
Almost 80-85% of the world’s population is affected by type 2 diabetes mellitus (T2DM) and the common controllable factors behind this disease’s profound presence include unhealthy eating habits, sedentary lifestyle, excess body weight, and irregular sleeping patterns. Besides these, some uncontrollable factors such as heredity and ethnicity seem to increase the risk. While we can’t do anything about such factors, we can always do something about controllable factors to keep diabetes at bay.
 
The Human Gut
 
The human gut is a complex collection of trillions of microorganisms that coexist peacefully in the gastrointestinal tract. Every human being has a unique microbiota composed of microorganisms from the environment, during delivery from the birth canal, and through breast milk. Though the initial set of microorganisms found in the infant are exclusively dependent on the ones found in the mother, environmental exposure and the diet regimen determine the microbiome’s composition as the child grows up.
 
The gut microbes play a crucial role in affecting the immune, metabolic, and neurobehavioral traits besides ensuring the smooth functioning of different body operations. Recent studies and research point towards the fact that the gut microbiota has a definite role in inducing the risk of T2DM. Though the initial studies were not conclusive, varied in results, and were not large-scale one, we have long-term research done during recent times in various geographical locations that clearly observed that different microbes showed the same outcomes in various geographical areas.
 
Relationship Between T2DM & Gut Microbiota
 
Of all the studies that dealt with the relationship between T2DM and gut microbiota, most of them have clearly found a strong association between specific groups of microorganisms and their impact on diseases. Genera of Ruminococcus, Blautia, and Fusobacterium trigger the risk of diabetes while the genera of Faecalibacterium, Akkermansia, Roseburia, Bifidobacterium, and Bacteroides don’t pose a threat to the disease. Among the studies, the Lactobacillus genus seem to provide inconclusive results in most studies. Moreover, Bifidobacterim seem to contain microbes that offer protection against the development of T2DM.
           
Another research found that there was a huge difference in the microorganism composition of individuals with and without diabetes. The research showed that those with obesity problems have a gut composition that increases the likeliness of developing diabetes. The bacteria of those individuals with diabetes evolved from the intestine and has the tendency to become more permeable when someone suffers from obesity.
 
On the brighter side, we have a large-scale study that distinctly showed that increased presence of 12 taxa benefited the risk of type 2 diabetes and insulin resistance. The greater the diversity between the microorganisms in the gut, the lower the risk of T2DM independent of food intake, exercise routine, sleep activity, and use of medications. Especially the presence of butyrate-producing bacteria increased the protective quotient against diabetes. 
 
The microbiota might influence proinflammatory activities, body weight, bile-acid metabolism, modulate gut hormones, and insulin resistance resulting in the pathogenesis of T2DM. It’s here that prebiotics, probiotics, antibiotics, and fecal microbiota transplants might lead to improvements in insulin resistance and glucose metabolism.
 
How Does the Gut Microbiota Change Glucose Metabolism?
 
There are multiple ways in which the gut microbiota affect insulin and glucose metabolism:
 

• Inflammatory cascades are activated thereby leading to cytokines hormone release
• metabolites production while fermentation and the secondary effects they produce
• triggering toxins inflow by affecting the permeability of the intestinal mucosal barrier
• Using incretin secretion as a medium for direct signalling action

 
Altering the Gut Composition with Diet
 
The presence of a well-balanced microorganism population is a sure guarantee for good gut health. Any disturbance to the composition of the gut microbiome can lead to fatigue, affect mental health, bring about mood changes, decrease immunity, and increase the risk of stress and cancer. Considering these, there are increased chances of the occurrence of multiple hormonal and metabolic disorders including diabetes, hypertension, obesity, insulin resistance, PCOS, and cardiovascular disease.
 
The big question mark now is balancing the microbiome composition to maintain body health. Besides genes, the environment, and use of medication, a popular factor that controls the diversity of the gut microbiota includes the types of food consumed. Any diet rich in fiber content has a profound effect on the quantity and type of gut microbiota in the intestines. We must understand that the enzymes from the microbiota of the colon are solely responsible for breaking down and fermenting dietary fibre which releases short chain fatty acids (SCFA). Such SCFA are released when consuming indigestible fibres and carbohydrates such as gums, inulin, resistant starches, and fructooligosaccharides which fall under the category of ‘prebiotics.’
 
It is also suggested to include fermented foods such as yogurt, kefir, pickled veggies, kimchi, kombucha tea, saurekraut, and miso to include probiotics in the diet. Please don’t consume too much of these foods suddenly as they can cause bloating and gas. Gradually include high-fiber foods in daily diet and witness improvements in gut microbiota composition.
 
Conclusion
 
Currently, our knowledge is restricted to the understanding that there is a link between gut microbiota composition and pathogenesis of type 2 diabetes. We need more detailed research to understand the intricate relationship between the gut, the host, and the evolvement of T2DM so that we can move ahead to the next step of developing efficient treatment methodologies for attacking diabetes.
 
There are indications that the gut microbiota might be valuable for procuring drug therapy for T2D. But, there have only been a few studies that have dwelled into this area of how changing the gut composition changes the effects of the anti-diabetic drugs. Researchers are hoping that in the future, coming up with a personalized and precise diagnosis alongside diabetes treatments plans would become a reality using gut microflora interventions. So, we can hope for a day where the gut composition doesn’t stay as a biomarker for diabetes but also provides help in treatment procedures.
Until then, take up the responsibility of managing a healthy gut composition by eating fiber-rich and healthy foods, exercising regularly, and leading an active lifestyle. Get in touch with a dietitian/nutritionist to help you plan a well-balanced diet plan that ensures good overall health including gut health and decreased risk of diabetes.