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. 2023 Nov 15:14:1265696.
doi: 10.3389/fendo.2023.1265696. eCollection 2023.

Gut microbiome and blood glucose control in type 1 diabetes: a systematic review

Jumana Abuqwider  1 , Alessandra Corrado  1 , Giuseppe Scidà  1 , Roberta Lupoli  2 , Giuseppina Costabile  1 , Gianluigi Mauriello  3 , Lutgarda Bozzetto  1
Affiliations

Gut microbiome and blood glucose control in type 1 diabetes: a systematic review

Jumana Abuqwider et al. Front Endocrinol (Lausanne). .

Abstract

Objective: The risk of developing micro- and macrovascular complications is higher for individuals with type 1 diabetes (T1D). Numerous studies have indicated variations in gut microbial composition between healthy individuals and those with T1D. These changes in the gut ecosystem may lead to inflammation, modifications in intestinal permeability, and alterations in metabolites. Such effects can collectively impact the metabolic regulation system, thereby influencing blood glucose control. This review aims to explore the relationship between the gut microbiome, inflammation, and blood glucose parameters in patients with T1D.

Methods: Google Scholar, PubMed, and Web of Science were systematically searched from 2003 to 2023 using the following keywords: "gut microbiota," "gut microbiome," "bacteria," "T1D," "type 1 diabetes," "autoimmune diabetes," "glycemic control," "glucose control," "HbA1c," "inflammation," "inflammatory," and "cytokine." The examination has shown 18,680 articles with relevant keywords. After the exclusion of irrelevant articles, seven observational papers showed a distinct gut microbial signature in T1D patients.

Results: This review shows that, in T1D patients, HbA1c level was negatively correlated with abundance of Prevotella, Faecalibacterium, and Ruminococcaceae and positively correlated with abundance of Dorea formicigenerans, Bacteroidetes, Lactobacillales, and Bacteriodes. Instead, Bifidobacteria was negatively correlated with fasting blood glucose. In addition, there was a positive correlation between Clostridiaceae and time in range. Furthermore, a positive correlation between inflammatory parameters and gut dysbiosis was revealed in T1D patients.

Conclusion: We draw the conclusion that the gut microbiome profiles of T1D patients and healthy controls differ. Patients with T1D may experience leaky gut, bacterial translocation, inflammation, and poor glucose management due to microbiome dysbiosis. Direct manipulation of the gut microbiome in humans and its effects on gut permeability and glycemic control, however, have not been thoroughly investigated. Future research should therefore thoroughly examine other potential pathophysiological mechanisms in larger studies.

Keywords: 16S rRNA; autoimmue diabetes; glycated hemoglobin; serum glucose level; shotgun sequencing; time in range.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
PRISMA flowchart showing the progression of articles through the various stages of the selection procedure.
Figure 2
Figure 2
Comparison between healthy situation and type 1 diabetes in terms of gut microbiome, gut permeability, and inflammation parameters.
Figure 3
Figure 3
Possible link among gut dysbiosis, gut barrier permeability (reduction of zonulin and SCFA), LPS translocation across epithelial cells, systemic inflammation (increase of cytokines like TNF, IL1 and IL6), increase in metabolic glucose phosphorylation, and increase in blood glucose level.
See this image and copyright information in PMC

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