Diabetes and the gut

The health benefits of probiotics in preventing or managing diabetes

Diabetes mellitus is a chronic, metabolic disease that occurs when the pancreas is unable to produce enough insulin or when the body does not use the insulin effectively (insulin resistance). This results in the elevation of blood glucose levels – hyperglycaemia, as insulin is the hormone that helps regulate the metabolism of carbohydrates in the body by signalling cells to take in glucose from the bloodstream  

It is important to maintain blood glucose levels in the normal range to prevent or delay complications related to long-term uncontrolled diabetes such as 

🔸 Retinopathy (vision) 
🔸 Diabetic kidney disease (chronic kidney disease) 
🔸 Neuropathy (nerve damage) 
🔸 Cardiovascular disease (heart) 
🔸 Diabetic foot (foot) 
🔸 Mental health issue 
🔸 Periodontal disease (oral health) 

These are eight factors that can increase the risk of diabetes: 

🔺 Age above 40 
🔺 Inactive lifestyle 
🔺 High blood pressure 
🔺 History of gestational diabetes or delivery of macrosomic baby (baby over 4kg) 
🔺 Impaired glucose tolerance (being pre-diabetic) 
🔺 Abnormal blood lipid levels 
🔺 BMI above 23kg/m2 
🔺 Family history of diabetes 

However, recent studies have shown the loss of diversity in the gut microbiome may slow down metabolism and weight gain, leading to T2DM.  

Here are some of the health benefits of probiotics in preventing or managing diabetes: 

  1. Regulate lipid metabolism 

The gut microbiota has been shown to affect lipid metabolism and lipid levels in tissues as well as in blood. Gut microbiota changes the integrity of intestinal epithelial cells and the intestine regulates cholesterol metabolism in the liver, promotes lipid oxidation in muscles, and regulates lipid storage in adipose tissue, thereby regulating lipids’ metabolic balance. 

  1. Reduce inflammation 

An increase in gut microbiota diversity helps in decreasing inflammation by reducing lipopolysaccharide (LPS) leakage. LPS are the major component of the outer membranes of gram-negative bacteria. It can penetrate the bloodstream via impaired permeability of the intestinal mucosa, which induces inflammation, impaired glucose metabolism, insulin resistance, and obesity, and contributes to the development of diabetes. Hence, the gut microbiome is important to maintain local gut integrity and systemic host homeostasis, where optimal control of intestinal LPS activity may play a significant role. 

  1. Weight management 

Gut microbes have also been shown to have positive effects on BMI by influencing diet and behaviour. It has a leading role to play in curbing appetite and helping to decrease overeating by promoting the release of appetite-suppressing hormones. Studies also found that probiotics have potential effects on mood, leading to higher restraint when it comes to overeating. 

  1. Improve insulin sensitivity 

Probiotics were found to lower fasting blood glucose, improve HbA1c and insulin resistance through improve inflammation and prevent beta-cell destruction. Beta cells in the pancreas produce and release insulin in response to blood glucose levels. Long-term uncontrolled hyperglycaemia requires beta cells to work harder so they can produce enough insulin to lower blood glucose levels. This overwork can lead to the loss of beta cells or the inability of beta cells to carry out their function effectively. Hence, probiotics can improve insulin sensitivity as it has a protective and restorative effect on β-cells.  

Overall, a balance and diversification of the gut microbiome have beneficial effects in regulating lipid metabolism, reducing inflammation, weight management, and improving insulin sensitivity.


Sharma, S. and Tripathi, P., 2019. Gut microbiome and type 2 diabetes: where we are and where to go?. The Journal of nutritional biochemistry, 63, pp.101-108. 

Jia, X., Xu, W., Zhang, L., Li, X., Wang, R. and Wu, S., 2021. Impact of gut microbiota and microbiota-related metabolites on hyperlipidemia. Frontiers in Cellular and Infection Microbiology, p.685. 

Schoeler, M. and Caesar, R., 2019. Dietary lipids, gut microbiota and lipid metabolism. Reviews in Endocrine and Metabolic Disorders, 20(4), pp.461-472. 

Boulangé, C.L., Neves, A.L., Chilloux, J., Nicholson, J.K. and Dumas, M.E., 2016. Impact of the gut microbiota on inflammation, obesity, and metabolic disease. Genome medicine, 8(1), pp.1-12. 

Cerdó, T., García-Santos, J.A., G. Bermúdez, M. and Campoy, C., 2019. The role of probiotics and prebiotics in the prevention and treatment of obesity. Nutrients, 11(3), p.635. 

Wiciński, M., Gębalski, J., Gołębiewski, J. and Malinowski, B., 2020. Probiotics for the treatment of overweight and obesity in humans—a review of clinical trials. Microorganisms, 8(8), p.1148. 

Scheithauer, T.P., Rampanelli, E., Nieuwdorp, M., Vallance, B.A., Verchere, C.B., Van Raalte, D.H. and Herrema, H., 2020. Gut microbiota as a trigger for metabolic inflammation in obesity and type 2 diabetes. Frontiers in immunology, p.2546. 

Caricilli, A.M. and Saad, M.J., 2013. The role of gut microbiota on insulin resistance. Nutrients, 5(3), pp.829-851. 

Jacie Chiew

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