Pharmacomicrobiomics and type 2 diabetes mellitus: A novel perspective towards possible treatment

Type 2 diabetes mellitus (T2DM), a major driver of mortality worldwide, is more likely to develop other cardiometabolic risk factors, ultimately leading to diabetes-related mortality. Although a set of measures including lifestyle intervention and antidiabetic drugs have been proposed to manage T2DM, problems associated with potential side-effects and drug resistance are still unresolved. Pharmacomicrobiomics is an emerging field that investigates the interactions between the gut microbiome and drug response variability or drug toxicity. In recent years, increasing evidence supports that the gut microbiome, as the second genome, can serve as an attractive target for improving drug efficacy and safety by manipulating its composition. In this review, we outline the different composition of gut microbiome in T2DM and highlight how these microbiomes actually play a vital role in its development. Furthermore, we also investigate current state-of-the-art knowledge on pharmacomicrobiomics and microbiome's role in modulating the response to antidiabetic drugs, as well as provide innovative potential personalized treatments, including approaches for predicting response to treatment and for modulating the microbiome to improve drug efficacy or reduce drug toxicity.

Automated summary

Type 2 diabetes mellitus (T2DM) is a major cause of mortality worldwide, often leading to other cardiometabolic risk factors and diabetes-related death. While lifestyle intervention and antidiabetic drugs have been proposed for T2DM management, issues like side effects and drug resistance remain unresolved. The emerging field of pharmacomicrobiomics examines the interplay between the gut microbiome and drug response or toxicity. Increasing evidence supports the gut microbiome as a target for improving drug efficacy and safety through composition manipulation. This review explores the distinct gut microbiome composition in T2DM, its role in disease development, and the potential for personalized treatments utilizing pharmacomicrobiomics.