Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2020; 11(7): 293-308
Published online Jul 15, 2020. doi: 10.4239/wjd.v11.i7.293
Gut microbiota and diabetes: From correlation to causality and mechanism
Wei-Zheng Li, Kyle Stirling, Jun-Jie Yang, Lei Zhang
Wei-Zheng Li, Lei Zhang, Microbiome-X, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
Wei-Zheng Li, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
Kyle Stirling, Luddy School of Informatics, Computing and Engineering, Indiana University, Bloomington, IN 47408, United States
Kyle Stirling, The Crisis Technologies Innovation Lab, Indiana University, The Information Technology Services and the Pervasive Technology Institute, Bloomington, IN 47408, United States
Kyle Stirling, Lei Zhang, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, Jinan 250000, Shandong Province, China
Jun-Jie Yang, College of Life Science, Qilu Normal University, Jinan 250000, Shandong Province, China
Jun-Jie Yang, Microbiome Research Center, Shandong Institutes for Food and Drug Control, Jinan 250000, Shandong Province, China
Jun-Jie Yang, Shandong Children’s Microbiome Center, Qilu Children's Hospital of Shandong University, Jinan 250000, Shandong Province, China
Jun-Jie Yang, Microbiological Laboratory, Lin Yi People’s Hospital, Linyi 276000, Shandong Province, China
Jun-Jie Yang, Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Lei Zhang, Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250000, Shandong Province, China
Lei Zhang, Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250000, Shandong Province, China
Lei Zhang, Shandong Children’s Microbiome Center, Research Institute of Pediatrics, Qilu Children's Hospital, Cheeloo College of Medicine, Shandong University, and Jinan Children's Hospital, Jinan 250022, Shandong Province, China
Author contributions: Zhang L designed the framework and supervised the preparation; Li WZ collected all references, wrote the manuscript, prepared the figure and table; Stirling K, Yang JJ and Zhang L contributed to thorough revision of the manuscript; All authors have read and approve the final manuscript.
Supported by Shandong Provincial Key Research and Development Program, No. 2018CXGC1219; City of Weihai Technique Extension Project, No. 2016GNS023; TaiShan Scholars Program of Shandong Province, No. tshw20120206; and TaiShan Industrial Experts Program, No. tscy20190612.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lei Zhang, PhD, Chairman, Professor, Microbiome-X, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Key Laboratory of Big Data-Based Precision Medicine, Beihang University, No. 37, Xueyuan Road, Haidian District, Beijing 100191, China. microbiome@foxmail.com
Received: February 29, 2020
Peer-review started: February 29, 2020
First decision: April 7, 2020
Revised: May 21, 2020
Accepted: June 10, 2020
Article in press: June 10, 2020
Published online: July 15, 2020
Processing time: 135 Days and 17.3 Hours
Abstract

In this review, we summarize the recent microbiome studies related to diabetes disease and discuss the key findings that show the early emerging potential causal roles for diabetes. On a global scale, diabetes causes a significant negative impact to the health status of human populations. This review covers type 1 diabetes and type 2 diabetes. We examine promising studies which lead to a better understanding of the potential mechanism of microbiota in diabetes diseases. It appears that the human oral and gut microbiota are deeply interdigitated with diabetes. It is that simple. Recent studies of the human microbiome are capturing the attention of scientists and healthcare practitioners worldwide by focusing on the interplay of gut microbiome and diabetes. These studies focus on the role and the potential impact of intestinal microflora in diabetes. We paint a clear picture of how strongly microbes are linked and associated, both positively and negatively, with the fundamental and essential parts of diabetes in humans. The microflora seems to have an endless capacity to impact and transform diabetes. We conclude that there is clear and growing evidence of a close relationship between the microbiota and diabetes and this is worthy of future investments and research efforts.

Keywords: Diabetes; Microbiota; Causality; Mechanism; Type 1 diabetes; Type 2 diabetes; Insulin resistance; Inflammation; Metabolites

Core tip: Current research continues to uncover associations between microbiota and diabetes [type 1 diabetes (T1D) and type 2 diabetes (T2D)], and these appear to involve metabolic effects and immune response processes. Understanding the consequences of balance in human gut microbiota and diabetes may prove very useful in developing future therapeutic interventions. This review summarizes recent studies in both mouse models and human cases that support a potential cause-effect relationship, and discusses the role of gut microbial metabolites on T1D and T2D.