Influence of gut flora on diabetes management after kidney transplantation

Abstract

Post-transplant diabetes mellitus (PTDM) is a common complication following renal transplantation, and its incidence has been gradually increasing in recent years, posing a significant public health challenge. Managing PTDM is complex, as studies suggest that it involves changes in the microbial flora across multiple organs. Recent research highlights the critical role of gut flora metabolism in the development of diabetes among post-renal transplant patients. This paper reviews the alterations in gut flora observed in PTDM patients and explores how gut flora influences PTDM. These findings may offer new perspectives on targeting gut flora metabolites for the prevention and treatment of PTDM.

Keywords: Diagnosis; Gut microbiota; Kidney transplantation; Outcome; Post-transplant diabetes mellitus.

Fig. 1

BA and diabetes after kidney transplantation. Under different conditions of glucose stimulation, impaired BA signaling can be triggered by multiple mechanisms leading to the development of PTDM. TGR5: M-BAR or Gpbar1. FXR:Farnesoid X receptor

Fig. 2

The relationship between probiotics and the gut barrier. Probiotics play a significant role in improving the intestinal barrier while exerting anti-PTDM effects, including improving the intestinal microbial barrier, improving the intestinal mechanical barrier, improving the intestinal chemical barrier, and improving the intestinal immune barrier, among others. AMPs: antimicrobial peptides; TJ proteins: tight junction proteins; DC: dendritic cell; TLR⁃4: Toll-like receptor 4