{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:33:49Z","timestamp":1793727229880,"version":"4.6.1"},"reference-count":67,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009392","name":"Prince Sattam bin Abdulaziz University","doi-asserted-by":"crossref","award":["PSAU\/2024\/01\/32069"],"award-info":[{"award-number":["PSAU\/2024\/01\/32069"]}],"id":[{"id":"10.13039\/100009392","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The rapidly advancing field of gut microbiota research has revealed its pivotal role in human health, with growing evidence implicating microbial dysbiosis in the development of metabolic diseases, particularly type 2 diabetes mellitus (T2DM). This narrative review synthesizes recent findings on the complex, bidirectional relationship between the gut microbiota\u2013metabolic axis and T2DM, drawing upon data from human and experimental studies published in the past decade. Patients with T2DM consistently demonstrate marked gut dysbiosis, characterized by reduced microbial diversity and depletion of beneficial butyrate-producing taxa such as Faecalibacterium prausnitzii and Roseburia intestinalis. In contrast, increases in pro-inflammatory bacteria including Escherichia-Shigella and Lactobacillus are commonly observed. Such compositional changes are linked to metabolic dysfunction through altered microbial metabolites, including elevated trimethylamine N-oxide (TMAO), which has been associated with insulin resistance and increased diabetes risk. Moreover, gut microbiota imbalances correlate with systemic inflammation, as indicated by higher levels of cytokines such as IFN-\u03b3 and IL-6. These findings underscore the gut microbiota\u2019s central role in energy metabolism and inflammation in T2DM. Understanding these mechanisms could inform novel therapeutic and preventive strategies\u2014such as microbiota-targeted dietary, probiotic, or pharmacologic interventions\u2014to improve metabolic outcomes and enhance clinical management of diabetes.<\/jats:p>","DOI":"10.3390\/medicina61112017","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T14:28:59Z","timestamp":1762871339000},"page":"2017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Gut Microbiota\u2013Metabolic Axis: Emerging Insights from Human and Experimental Studies on Type 2 Diabetes Mellitus\u2014A Narrative Review"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6412-4013","authenticated-orcid":false,"given":"Mohammed Saad","family":"Alqahtani","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1038\/s41579-024-01075-5","article-title":"The oral-gut microbiome axis in health and disease","volume":"22","author":"Kunath","year":"2024","journal-title":"Nat. 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