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Forum participants included clinicians and basic scientists who are leading investigators in the field of the intestinal microbiome and metabolism. Their conclusions were as follows: (1) the GM may be involved in the pathophysiology of type 2 diabetes, as microbially produced metabolites associate both positively and negatively with the disease, and mechanistic links of GM functions (e.g. genes for butyrate production) with glucose metabolism have recently emerged through the use of Mendelian randomisation in humans; (2) the highly individualised nature of the GM poses a major research obstacle, and large cohorts and a deep-sequencing metagenomic approach are required for robust assessments of associations and causation; (3) because single time point sampling misses intraindividual GM dynamics, future studies with repeated measures within individuals are needed; and (4) much future research will be required to determine the applicability of this expanding knowledge to diabetes diagnosis and treatment, and novel technologies and improved computational tools will be important to achieve this goal.<\/jats:p>","DOI":"10.1007\/s00125-024-06198-1","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T01:01:20Z","timestamp":1719190880000},"page":"1760-1782","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The gut microbiota and diabetes: research, translation, and clinical applications \u2013 2023 Diabetes, Diabetes Care, and Diabetologia Expert Forum"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-4156","authenticated-orcid":false,"given":"Mariana","family":"Byndloss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5575-9362","authenticated-orcid":false,"given":"Suzanne","family":"Devkota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1760-4081","authenticated-orcid":false,"given":"Frank","family":"Duca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6902-5650","authenticated-orcid":false,"given":"Jan Hendrik","family":"Niess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1926-7659","authenticated-orcid":false,"given":"Max","family":"Nieuwdorp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3578-2503","authenticated-orcid":false,"given":"Marju","family":"Orho-Melander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1615-1976","authenticated-orcid":false,"given":"Yolanda","family":"Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9150-4233","authenticated-orcid":false,"given":"Valentina","family":"Tremaroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9694-7140","authenticated-orcid":false,"given":"Liping","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"6198_CR1","doi-asserted-by":"publisher","first-page":"15718","DOI":"10.1073\/pnas.0407076101","volume":"101","author":"F B\u00e4ckhed","year":"2004","unstructured":"B\u00e4ckhed F, Ding H, Wang T et al (2004) The gut microbiota as an environmental factor that regulates fat storage. 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The authors also thank Robert Caesar and Anna Hallen of Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden, for their help with the figures. Portions of the content of this article were presented at a symposium at the 59th Annual Meeting of the European Association for the Study of Diabetes on 6 October 2023 in Hamburg, Germany.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"The 2023 <i>Diabetes<\/i>, <i>Diabetes Care<\/i>, and <i>Diabetologia<\/i> expert forum \u2018The microbiome and diabetes: research, translation and clinical applications\u2019, including a subsequent symposium presented on this topic and the preparation of this article, was supported by a grant from the Novo Nordisk Foundation (NNF23SA0085453). MB is a Howard Hughes Medical Institute Freeman Hrabowski Scholar and is supported by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant NIDDK R01DK131104, the Pew Charitable Trusts (2022-A-19568), and the Burroughs Wellcome Fund Investigators in the Pathogenesis of Infectious Disease (022792). SD is supported by NIDDK grants NIDDK R01DK123446 and 1DP1 DK130687. JHN is supported by the Swiss National Science Foundation (SNSF) grant 310030_219210. MN is supported by a personal ZONMW-VICI grant 2020 (09150182010020) and a DFN-DON grant 2020 (2020.10.002). YS is supported by grants from the Spanish Ministry of Science, Innovation and Universities MICIU\/AEI (PID2020-119536RB-I00) and Severo Ochoa Center of Excellence (ref. CEX2021- 001189-S\/10.13039\/501100011033). VT is a co-principal investigator of a research project funded by the European Union\u2019s Innovative Medicines Initiative (IMI grant 875534).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"JHN has served as an advisor for Abbvie, Bristol Myers Squibb, Falk, Janssen, Roche, and Takeda. MN is the founder and a scientific advisory board member of Caelus Pharmaceuticals and Advanced Microbiome Interventions in Amsterdam, the Netherlands. YS is co-author of patents based on the use of intestinal bacteria for obesity and metabolic comorbidities. VT holds a patent for the use of microbiota in type 2 diabetes. LZ is a co-founder of Notitia Biotechnologies, a microbiome company providing products related to diabetes. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"All authors contributed to writing, reviewing, and revising the manuscript and approved the final version for submission. MO-M is the guarantor of this work and, as such, takes responsibility for the integrity of the review.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}