THE GUT MICROBIOME: A NOVEL ENDOCRINE ORGAN IN TYPE 2 DIABETES PATHOGENESIS AND MANAGEMENT

Maria Anam, Manisha Timalsena, Priya Bai, Shewani, Sara Shafi Rahu, Hareem Shahid, Hassan Riaz and *Hussain Ramzan

Type 2 diabetes (T2D) is a major global health issue, with rates still on the rise. Projections indicate that over 700 million adults could be affected by 2045. While we know traditional risk factors like genetics, obesity, and lifestyle, the human gut microbiome has become an important factor in the disease’s development and a possible target for new treatment strategies. This narrative review summarizes current research on the complex relationship between the gut microbiome and T2D. It looks into the changes in microbial composition and function seen in dysbiosis and how gut microbes affect glucose balance in the body. We discuss how microbial metabolites, like short-chain fatty acids, bile acids, and branched-chain amino acids, interact with the body to influence insulin sensitivity, inflammation, and gut barrier health. The review also examines the potential of microbiome-focused interventions, such as dietary changes, prebiotics, probiotics, and fecal microbiota transplantation, as supplements to standard T2D treatments. A key focus is the effect of glucose-lowering medications, particularly metformin, on the gut microbiome, suggesting a possible two-way interaction. Despite encouraging findings, the field faces challenges like differences in study methods, the need for larger and more diverse groups, and the difficulty in turning correlational data into concrete causes and effective treatments. The review concludes that a better understanding of the gut microbiome's role in T2D could lead to personalized, microbiome-based diagnostics and treatments, thus improving diabetes management.