{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:29:33Z","timestamp":1788445773484,"version":"build-2803163510"},"reference-count":158,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Type 2 diabetes and insulin resistance are increasingly recognized as conditions influenced not only by genetic and lifestyle factors but also by infectious and microbial exposures. Diarrheagenic pathogens, including enterotoxigenic, enteroaggregative, and enterohemorrhagic Escherichia coli, as well as other enteric microorganisms, disrupt the gut microbiota and compromise intestinal barrier integrity. These alterations promote dysbiosis, increased intestinal permeability, and systemic exposure to lipopolysaccharides and other microbial products, leading to metabolic endotoxemia and chronic low-grade inflammation. In parallel, pathogen-induced modulation of host immune responses contributes to adipose tissue inflammation, mitochondrial dysfunction, and impaired insulin signaling. This review summarizes current evidence linking diarrheagenic pathogens to insulin resistance, with emphasis on the microbiota\u2013immune\u2013metabolism axis. Understanding these interactions highlights novel perspectives on the pathogenesis of insulin resistance and suggests that targeted modulation of the gut microbiota or reduction in pathogen-driven inflammation may represent therapeutic opportunities to improve metabolic outcomes.<\/jats:p>","DOI":"10.3390\/ijms27031610","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:32:59Z","timestamp":1770395579000},"page":"1610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Enteric Infections, Dysbiosis, and Metabolic Dysfunction: The Role of Diarrheagenic Pathogens in Insulin Resistance"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3631-0281","authenticated-orcid":false,"given":"Martin","family":"Zerme\u00f1o-Ruiz","sequence":"first","affiliation":[{"name":"Doctorado en Microbiolog\u00eda M\u00e9dica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico"},{"name":"Departamento de Farmacobiolog\u00eda, Centro Universitario de Ciencias Exactas e Ingenier\u00edas, Universidad de Guadalajara, Blvd. Marcelino Garc\u00eda Barrag\u00e1n #1421, Guadalajara 44430, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9243-1390","authenticated-orcid":false,"given":"Filiberto","family":"Gutierrez-Gutierrez","sequence":"additional","affiliation":[{"name":"Departamento de Farmacobiolog\u00eda, Centro Universitario de Ciencias Exactas e Ingenier\u00edas, Universidad de Guadalajara, Blvd. Marcelino Garc\u00eda Barrag\u00e1n #1421, Guadalajara 44430, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9384-201X","authenticated-orcid":false,"given":"Elsa Janneth","family":"Anaya-Ambriz","sequence":"additional","affiliation":[{"name":"Doctorado en Microbiolog\u00eda M\u00e9dica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico"},{"name":"Departamento de Ciencias de la Salud, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca 46708, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3364-0913","authenticated-orcid":false,"given":"Emiliano","family":"Pe\u00f1a-Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Licenciatura en M\u00e9dico Cirujano y Partero, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2120-1819","authenticated-orcid":false,"given":"Jes\u00fas Jonathan","family":"Garc\u00eda-Galindo","sequence":"additional","affiliation":[{"name":"Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Calle Sierra Mojada 950, Independencia Oriente, Guadalajara 44340, Mexico"},{"name":"Institute of Experimental and Clinical Terapeutics (INTEC), Health Science University Center, Universidad de Guadalajara, Guadalajara 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Huerta-Huerta","sequence":"additional","affiliation":[{"name":"Hospital Medica de la Ciudad, Santa Catalina, Calle. Pablo Valdez 719, La Perla, Guadalajara 44360, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araceli Lizbeth","family":"Qui\u00f1onez-Gallardo","sequence":"additional","affiliation":[{"name":"Hospital Medica de la Ciudad, Santa Catalina, Calle. Pablo Valdez 719, La Perla, Guadalajara 44360, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-213X","authenticated-orcid":false,"given":"Daniel Osmar","family":"Su\u00e1rez-Rico","sequence":"additional","affiliation":[{"name":"Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Calle Sierra Mojada 950, Independencia Oriente, Guadalajara 44340, Mexico"},{"name":"Institute of Experimental and Clinical Terapeutics (INTEC), Health Science University Center, Universidad de Guadalajara, Guadalajara 44340, Mexico"},{"name":"Hospital Medica de la Ciudad, Santa Catalina, Calle. 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