From Dysbiosis to Diabetes: How Gut Microbiome Interventions Influence Type 2 Diabetes.

Abstract

Type 2 Diabetes (T2D) is a complex metabolic disorder associated with insulin resistance (IR), chronic low-grade inflammation, and dysregulated glucose metabolism. Increasing evidence suggests that gut microbiota imbalances, or dysbiosis, may play a key role in its development and progression. This review aims to critically evaluate the existing literature on the role of gut microbiome-targeted interventions, specifically prebiotics and probiotics, in the prevention and management of T2D. The review highlights that prebiotics have shown modest benefits in improving insulin sensitivity and lowering fasting blood glucose (FBG), particularly in individuals with early metabolic dysfunction. Probiotic interventions using strains like Lactobacillus and Bifidobacterium have demonstrated variable outcomes, with some studies reporting improvements in glycaemic control and inflammatory markers. Proposed mechanisms include increased production of short-chain fatty acids (SCFAs), improved gut barrier integrity, and modulation of bile acids. However, findings remain inconsistent because studies differ in design, population characteristics, intervention type, and outcome measures. Taken together, the evidence suggests that microbiome- based therapies show early potential for influencing pathways involved in the development and management of type 2 diabetes, although current effects are modest. Larger and longer-term trials are needed to confirm efficacy, clarify mechanisms, and determine which individuals are most likely to respond to probiotic or prebiotic interventions.