Role of Gut Microbiota in Type 2 Diabetic Patients

Abstract

In terms of global health, type 2 diabetes (T2D) is a serious issue and has an impact on millions of individuals worldwide. T2D development has been connected to gut microbiota dysbiosis. Consequently, investigating the gut microbiota (GM) of individuals with T2D is crucial for comprehending the disease and creating effective treatment methods. The purpose of this present study was to examine the GM of patients with T2D and identify specific taxonomic associations related to metformin medication. The study included ninety-four adult participants, both with and without T2D. Geographical, anthropometric, and dietary-based questionnaires were recorded from the volunteers. Blood and fecal samples were collected from the volunteers. Blood was assessed for HbA1c, lipid profile, and circulating lipopolysaccharide-binding proteins (LBP). Plasma was used to assess the ability of LBP to activate Tol-like receptors (TLRs) in the in-vitro using TLR-specific cell lines. The fecal samples were assessed for microbial (bacterial and fungal) profiles and butyrate-producing abilities. The 16S rRNA and ITS genes were sequenced for microbial communities’ assessment. Eubacteria and butyrate genes were assessed through qPCR. The data were also compared with publicly similar available datasets. The results revealed that T2D belonged to the rural regions of Punjab and Khyber Pakhtunkhwa, Pakistan. Their BMI was (27.5), and they were frequent users of meat, fast, and deep-fried foods. In comparison to healthy volunteers, T2D patients had increased concentrations of blood HbA1c (7.55 mmol/mol), total cholesterol (177.5 mg/dL), triglycerides (245 mg/dL), low-density lipoproteins (104 mg/dL) and circulating LBP (24.52 ng/ml). LBP significantly (p = 0.001) activated the TLRs, specifically TLR2. Lower α diversity and differential β diversity were found in the GM of people with T2D. At the phylum level, an elevated abundance of Proteobacteria was specifically linked to T2D, while at the genus level, Bifidobacteria, Streptococcus, and Clavispora were associated with the disease. Furthermore, there was an increase in the relative abundance of Libanicoccus/Parolsenella, which may hinder the generalizability of GM based classifiers for T2D across different populations. In summary, our findings highlight the importance of incorporating understudied populations to enhance the effectiveness of microbiota-based diagnostics and treatment.