Dysbiosis of the intestinal microbiota and type 2 diabetes mellitus, modern correction strategies: A review

Abstract

Diabetes mellitus has now assumed an epidemic character and acquired the characteristics of a pandemic disease. In recent decades, special attention has been paid to the importance of the intestinal microbiome in the pathogenesis of diabetes. The purpose of the review was to study the correlation between the intestinal microbiota and type 2 diabetes mellitus (DM 2), to assess the prospects for the prevention and treatment of DM 2 by correcting dysbiotic disorders. Studies of the intestinal microbiota have shown a correlation between plasma glucose levels and changes in the composition of the microbiota, namely with a decrease in representatives of the Firmicutes type and an increase in Proteobacteria, a change in the ratio of Bacteroidetes to Firmicutes. In patients with DM 2, the population of butyrate-producing bacteria decreases against the background of the growth of opportunistic opportunists, mucin-decomposing bacteria and sulfite-reducing bacteria. The presence of a link between the composition of intestinal microbiota and DM 2 was confirmed during experimental studies on animal models and on groups of volunteers. New approaches to studying the risk of developing DM 2 and dysbiotic disorders may be associated with the use of artificial intelligence. A promising direction for the use of probiotic microorganisms for the correction of metabolic disorders of DM 2 is the use of both classical probiotics – representatives of the genera Lactobacillus and Bifidobacterium, as well as new probiotics from the intestinal normobiota Akkermansia muciniphila, Faecalibacterium prausnitzii and genetically modified microorganisms Lactococcus lactis (LL-pUBGLP-1). One of the new techniques for correcting dysbiotic disorders in DM 2 is fecal microbiota transplantation. The intestinal microbiota can be used not only as a diagnostic biomarker of DM 2, but also as a potential target for the development of new therapeutic approaches. The use of prebiotics, probiotics, postbiotics and pharmacobiotics, which can have a therapeutic effect by influencing the pathogenetic mechanisms in DM 2, requires further multicenter studies using multiomic technologies.

Keywords

• type 2 diabetes mellitus
• intestinal microbiota
• metagenomics
• fecal transplantation
• probiotic therapy