Gut bacterial shifts may signal type 2 diabetes before blood sugar changes
Research presented at the EASD meeting indicates that changes in gut microbiome composition can appear before blood glucose abnormalities. An analysis of hundreds of thousands of people identified many microbial alterations associated with type 2 diabetes risk. The findings suggest microbiome profiling could help target lifestyle interventions earlier.
The study pooled metagenomic and health records from 229,025 adults, mostly female, average age 50. It included 3,627 type 2 diabetes cases, 14,022 prediabetes cases, and 211,376 people with normal glucose. After adjusting for age, sex, and BMI, researchers linked 789 bacterial species to type 2 diabetes: 168 were enriched and 621 depleted.
Among examples, Enterocloster bolteae was more common in type 2 diabetes and has been associated with less favorable heart and metabolic outcomes; Romboutsia timonensis was less common. Some implicated species remain uncultured. Associations also appeared in unmedicated prediabetes, with 587 species linked.
If validated, microbiome profiling may offer earlier risk signals for adults who currently have normal blood sugar but later develop T2D. It could help clinicians and public health programs direct diet and lifestyle support to those at higher risk, potentially reducing diagnoses. However, access, cost, and whether changes are causal remain uncertain; benefits may depend on equitable implementation and follow-up care.