Decoding the Gut Microbiota-Gestational Diabetes Link: Insights from the Last Seven Years

Abstract

The human microbiome, a complex ecosystem of bacteria, viruses, and protozoans living in symbiosis with the host, plays a crucial role in human health, influencing everything from metabolism to immune function. Dysbiosis, or an imbalance in this ecosystem, has been linked to various health issues, including diabetes and gestational diabetes (GD). In diabetes, dysbiosis affects the function of adipose tissue, leading to the release of adipokines and cytokines, which increase inflammation and insulin resistance. During pregnancy, changes to the microbiome can exacerbate glucose intolerance, a common feature of GD. Over the past years, burgeoning insights into the gut microbiota have unveiled its pivotal role in human health. This article comprehensively reviews literature from the last seven years, highlighting the association between gut microbiota dysbiosis and GD, as well as the metabolism of antidiabetic drugs and the potential influences of diet and probiotics. The underlying pathophysiological mechanisms discussed include the impact of dysbiosis on systemic inflammation and the interplay with genetic and environmental factors. By focusing on recent studies, the importance of considering microbial health in the prevention and treatment of GD is emphasized, providing insights into future research directions and clinical applications to improve maternal-infant health outcomes.

Keywords: diabetes; drugs; gestational diabetes; microbiota; probiotics.

Figure 1

Comparative overview of the gut microbiota in Type 1, Type 2, and gestational diabetes (GD). The diagram illustrates distinctive microbial profiles associated with each diabetes type and their potential consequences on host metabolism and immune responses, emphasizing the microbiota’s role in disease mechanisms and therapeutic opportunities. This figure was created with BioRender software (https://biorender.com/, accessed on 18 March 2024).

Figure 2

Interplay between the gut microbiota and antidiabetic drug metabolism in pregnant women. This illustration depicts the influence of diet, health, genetics, and medications such as metformin and GLP-1 on microbiota diversity and function. It also highlights the potential resistance mechanisms to GLP-1 and the therapeutic interventions targeting the microbiome. This figure was created with BioRender software (https://biorender.com/, accessed on 18 March 2024).