How gut microbiota relate to the oral antidiabetic treatment of type 2 diabetes

The theory of ominous octet proposed by Dr. Defronzo in 2008 has emphasized the underlying complicated pathogenesis mechanism in type 2 diabetes. Recently it was further identified that gut microbiota dysbiosis is also closely related to development of chronic inflammations related diseases including diabetes. Diabetes is characterized by "leaky gut" syndrome where bacterial cell wall components enter the blood circulation of animal host in a higher amount. These may cause metabolic endotoxemia and systemic low-grade inflammation, affecting vital organs related to the ominous octet. On the other hand, the bacterial metabolites also systemically affect glucose homeostasis and energy utilization. The effects of current clinically available oral antidiabetic drugs (OAD) are related to altering the compositions of gut microbiota, among which metformin are the most extensively explored. Gut microbiota therefore play an important role as a functional cross-bridge between host environment and the ominous octet, modulating diabetes. With continuing explorations, in the future gut microbiota may serve as a diagnostic biomarker in personalized medicine. Its modulation may also be used as a novel approach to treat type 2 diabetes.