Gut Microbiome Dysbiosis in Type 2 Diabetes: MellitusMechanistic Pathways, Subtype Classification, and Therapeutic Interventions

Abstract

The global health burden of Type 2 Diabetes Mellitus (T2DM) is growing, with over 537 million adults estimated to be affected, rising to 783 million by 2045. Growing evidence shows that gut microbiome dysfunction plays an important role in the development of T2DM. Microbiome dysbiosis contributes to insulin resistance by multiple overlapping mechanisms and presumes the disruption of intestinal barrier functions (e.g., by endotoxins generated by Lipopolysaccharides [LPS]) and the depletion of Short-Chain Fatty Acids (SCFAs) by commensals such as Akkermansia muciniphila, Faecalibacterium prausnitzii, and Roseburia species.

Our research paper shows evidence from 83 original research studies sourced from PubMed, Scopus, Web of Science, and Embase (2015-2026). The meta-analysis reveals substantial reductions in Akkermansia muciniphila (Hedges’ g = -0.68, p = 0.002) and an overall decrease in HbA1c of -0.72% (95% CI -1.12% to -0.32%) after synbiotic treatment. As a result, we develop a model to discriminate between inflammatory-dominated and SCFA-depleted subtypes of dysbiosis for targeted curing approaches such as probiotics, synbiotics, dietary fiber modulation, and fecal microbiota transplantation. In conclusion, the gut microbiome is an effective diagnostic biomarker and a healing target for T2DM.

Keywords: Gut Microbiome; Dysbiosis; Type 2 Diabetes Mellitus; Short-Chain Fatty Acids

Citation

Adeel Asghar. Gut Microbiome Dysbiosis in Type 2 Diabetes: MellitusMechanistic Pathways, Subtype Classification, and Therapeutic Interventions. WebLog J Intern Med. wjim.2026.i1209. https://doi.org/10.5281/zenodo.22843219