The Gut Microbiome: Connecting Diet, Glucose Homeostasis, and Disease

Annu Rev Med. 2022 Jan 27:73:469-481. doi: 10.1146/annurev-med-042220-012821. Epub 2021 Oct 22.

Abstract

Type 2 diabetes rates continue to rise unabated, underscoring the need to better understand the etiology and potential therapeutic options available for this disease. The gut microbiome plays a role in glucose homeostasis, and diabetes is associated with alterations in the gut microbiome. Given that consumption of a Western diet is associated with increased metabolic disease, and that a Western diet alters the gut microbiome, it is plausible that changes in the gut microbiota mediate the dysregulation in glucose homeostasis. In this review, we highlight a few of the most significant mechanisms by which the gut microbiome can influence glucose regulation, including changes in gut permeability, gut-brain signaling, and production of bacteria-derived metabolites like short-chain fatty acids and bile acids. A better understanding of these pathways could lead to the development of novel therapeutics to target the gut microbiome in order to restore glucose homeostasis in metabolic disease.

Keywords: bile acids; diabetes; gut microbiota; high-fat diet; short-chain fatty acids.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diabetes Mellitus, Type 2*
  • Diet
  • Gastrointestinal Microbiome* / physiology
  • Glucose / metabolism
  • Homeostasis
  • Humans

Substances

  • Glucose