Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.
Drug Des Devel Ther. 2021 Nov 30;15:4849-4863. doi: 10.2147/DDDT.S334325. eCollection 2021.
Type 2 diabetes mellitus (T2DM) is a widespread metabolic disease characterized by chronic hyperglycemia. Human microbiota, which is regarded as a "hidden organ", plays an important role in the initiation and development of T2DM. In addition, anti-hyperglycemic agents and traditional Chinese medicine may affect the composition of gut microbiota and consequently improve glucose metabolism. However, the relationship between gut microbiota, T2DM and anti-hyperglycemic agents or traditional Chinese medicine is poorly understood. In this review, we summarized pre-clinical and clinical studies to elucidate the possible underlying mechanism. Some anti-hyperglycemic agents and traditional Chinese medicine may partly exert hypoglycemic effects by altering the gut microbiota composition in ways that reduce metabolic endotoxemia, maintain the integrity of intestinal mucosal barrier, promote the production of short-chain fatty acids (SCFAs), decrease trimethylamine-N-oxide (TMAO) and regulate bile acid metabolism. In conclusion, gut microbiota may provide some new therapeutic targets for treatment of patients with diabetes mellitus.
2 型糖尿病（T2DM）是一种广泛存在的代谢性疾病，其特征是慢性高血糖。人类微生物群被视为“隐藏的器官”，在 T2DM 的发生和发展中起着重要作用。此外，降糖药物和中药可能会影响肠道微生物群的组成，从而改善葡萄糖代谢。然而，肠道微生物群、T2DM 与降糖药物或中药之间的关系尚不清楚。在这篇综述中，我们总结了临床前和临床研究，以阐明可能的潜在机制。一些降糖药物和中药可能通过以下方式部分发挥降血糖作用：改变肠道微生物群组成，减少代谢内毒素血症，维持肠黏膜屏障的完整性，促进短链脂肪酸（SCFAs）的产生，降低三甲胺 N-氧化物（TMAO）水平，并调节胆汁酸代谢。总之，肠道微生物群可能为糖尿病患者的治疗提供一些新的治疗靶点。
