Intestinal microbiota in diabetes and its complications: mechanisms and therapeutic potentials

The incidence rate of diabetes is increasing year by year, and the role of intestinal microbiota in this process has garnered considerable attention. In type 1 diabetes, the imbalance of intestinal microbiota can lead to disease by disrupting the intestinal barrier, altering immune regulation, and changing metabolites and specific microbial abundance, all of which are influenced by age, genetics, environment, and other factors. The corresponding treatment strategies include prebiotics, probiotics, traditional Chinese medicine (TCM), and fecal microbiota transplantation, but still need to be optimized. Changes in intestinal microbiota composition and metabolites in patients with type 2 diabetes affect related signaling pathways. Besides, diet and drugs also affect intestinal microbiota and diseases. In terms of complications associated with diabetes, intestinal microbiota is closely linked to diabetic encephalopathy, nephropathy, retinopathy, neuropathy, and cardiomyopathy. It participates in the pathological process by regulating metabolism, influencing inflammatory reactions, and other mechanisms. Treatment strategies based on intestinal microbiota have potential in treating these complications, but face many challenges. This review focuses on the research progress of intestinal microbiota, diabetes, and its complications. In the future, in-depth exploration of molecular mechanisms and large-scale clinical research are still needed.