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World J Clin Cases. Jan 6, 2023; 11(1): 65-72
Published online Jan 6, 2023. doi: 10.12998/wjcc.v11.i1.65
Role of natural products and intestinal flora on type 2 diabetes mellitus treatment
Ozlem Celik Aydin, Sonay Aydın, Sureyya Barun
Ozlem Celik Aydin, Department of Medical Pharmacology, Erzincan Mengücek Gazi Training and Research Hospital, Erzincan 24100, Turkey
Sonay Aydın, Department of Radiology, Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Erzincan 24100, Turkey
Sureyya Barun, Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
Author contributions: Aydın S, Aydin OC, Barun S put forward the concept, were responsible for the design and supervision, did the literature search and reviewed the manuscript critically, were responsible for materials and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ozlem Celik Aydin, MD, Doctor, Department of Medical Pharmacology, Erzincan Mengücek Gazi Training and Research Hospital, Başbağlar, Hacı Ali Akın Cd. No. 32, Erzincan 24100, Turkey. ozlemclk_89@hotmail.com
Received: September 19, 2022
Peer-review started: September 19, 2022
First decision: October 21, 2022
Revised: November 12, 2022
Accepted: December 15, 2022
Article in press: December 15, 2022
Published online: January 6, 2023
Abstract

Diabetes mellitus (DM) is a complicated, globally expanding disease that is influenced by hereditary and environmental variables. Changes in modern society's food choices, physical inactivity, and obesity are significant factors in the development of type 2 DM (T2DM). The association between changes in intestinal flora and numerous disorders, including obesity, diabetes, and cardiovascular diseases, has been studied in recent years. The purpose of this review is to analyze the mechanisms underlying the alteration of the diabetic patients' intestinal flora, as well as their therapeutic choices. Also included is a summary of the anti-diabetic benefits of natural compounds demonstrated by studies. The short-chain fatty acids theory, the bile acid theory, and the endotoxin theory are all potential methods by which intestinal flora contributes to the establishment and progression of T2DM. Due to an intestinal flora imbalance, abnormalities in short-chain fatty acids and secondary bile acids have been found in diabetic patients. Additionally, metabolic endotoxemia with altering flora induces a systemic inflammatory response by stimulating the immune system via bacterial translocation. The agenda for diabetes treatment includes the use of short-chain fatty acids, probiotics, prebiotics in the diet, fecal bacteria transplantation, and antibiotics. Animal studies have proven the antidiabetic benefits of numerous bioactive substances, including Flavonoids, Alkaloids, Saponin, and Allicin. However, further research is required to contribute to the treatment of diabetes.

Keywords: Diabetes mellitus, Intestinal flora, Natural products, Endotoxemia, Bioactive compounds, Probiotics

Core Tip: It is thought that intestinal flora may have a role in the development of type 2 diabetes mellitus. This has been demonstrated in the treatment of type 2 diabetes mellitus and that the course of the disease might differ depending on the medications used for intestinal flora imbalance.