University La Sapienza, Rome, Italy.
Diabetes Metab Res Rev. 2014 Mar;30 Suppl 1:48-54. doi: 10.1002/dmrr.2518.
Type 2 diabetes mellitus (T2DM) is a complex disorder influenced by both genetic and environmental factors. Recent studies have suggested that an imbalance of the intestinal microbiota may be involved in the development of several human diseases, including obesity and T2DM. The main regulators of the intestinal microbiota are age, ethnicity, the immune system and diet. A high-fat diet may induce dysbiosis, which can result in a low-grade inflammatory state, obesity and other metabolic disorders. Adding prebiotics to the diet may reduce inflammation, endotoxaemia and cytokine levels as well as improving insulin resistance and glucose tolerance. The administration of prebiotics such as fermentable dietary fibres, promotes glucagon-like peptide 1 and peptide YY (anorexigenic) and decreases ghrelin (orexigenic). In a recent 21-day, intervention study in patients with T2DM, the effect of using the macrobiotic Ma-Pi 2 diet was investigated. Results suggested that it could induce a significant improvement in fasting blood glucose, plasma lipid fractions, plasma insulin and homeostasis. It is therefore possible that a diet rich in prebiotics and probiotics can play a role in T2DM management, probably due to positive intestinal microbiota modulation. However, this must be demonstrated by larger studies including randomized controlled trials that measure indicators of inflammation.
2 型糖尿病（T2DM）是一种受遗传和环境因素共同影响的复杂疾病。最近的研究表明，肠道微生物群的失衡可能与包括肥胖和 T2DM 在内的多种人类疾病的发生有关。肠道微生物群的主要调节剂是年龄、种族、免疫系统和饮食。高脂肪饮食可能会导致肠道微生物群失调，从而导致低度炎症状态、肥胖和其他代谢紊乱。在饮食中添加益生元可以降低炎症、内毒素血症和细胞因子水平，并改善胰岛素抵抗和葡萄糖耐量。添加可发酵膳食纤维等益生元可以促进胰高血糖素样肽 1 和肽 YY（厌食）的分泌，同时降低胃饥饿素（食欲）的分泌。在一项最近针对 T2DM 患者的为期 21 天的干预研究中，研究了采用宏量营养 Ma-Pi 2 饮食的效果。结果表明，它可以显著改善空腹血糖、血浆脂质成分、血浆胰岛素和血糖稳态。因此，富含益生元和益生菌的饮食可能在 T2DM 管理中发挥作用，这可能是由于对肠道微生物群的积极调节。然而，这必须通过包括测量炎症指标的随机对照试验在内的更大规模研究来证明。
