Dietary regulations for microbiota dysbiosis among post-menopausal women with type 2 diabetes

Figures & data

Table 1. A summary of post-menopausal ailments.

Illustration	Organ	Effect	Reference
	Liver	Higher Risk of nonalcoholic fatty liver disease	(Chen and Madak-Erdogan 2018; Wang, Gorelick, and Bhargava 2021)
	Skeletal muscles	Reduced insulin sensitivity, and glucose uptake	(Hevener et al. 2020)
	Adipose tissue	Reduced insulin sensitivity, and higher oxidative stress	(De Paoli, Zakharia, and Werstuck 2021)
	Cardiac tissue	Cardiac stroke, and endothelial dysregulation	(Lisabeth and Bushnell 2012)
	Pancreas	Higher risk of pancreatic carcinoma, and compromised function of β cells.	(De Paoli, Zakharia, and Werstuck 2021; Wang, Gorelick, and Bhargava 2021)
	Kidney	Higher chances of chronic kidney diseases	(Ahmed 2017)
	Bones	Osteoporosis, and higher risk of bone fracture	(Eastell et al. 2016)
	Breast Tissue	Increased risk of breast cancer	(Dashti et al. 2020; Qureshi et al. 2020)

Figure 1. Effect of estrogen; Estrogen affects various metabolic activities related to T2D, such as glucose metabolism, adiposity, systemic inflammation, etc., via its direct action and by involving gut-microbiota (ER = Estrogen receptor, ERE = Estrogen responsive element).

Figure 2. Impact of Post-menopausal Type 2 Diabetes; Post-menopausal type 2 diabetes affects the multiple regulators including gut microbiota to metabolism, and their impact can be seen on various T2D specific markers i.e., BMI, blood glucose level.

Table 2. Common gut associated adversities in post-menopausal women.

Post-menopausal adversities	Model	Study	Reference
Lower SCFA level	Mice	SCFA regulate systemic bone mass	(Lucas et al. 2018)
	Human	Depletion of butyrate producers in postmenopausal gut microbiota	(Zhao et al. 2019)
Gut dysbiosis	Human	Gut microbiota features and metabolic markers in postmenopausal women	(Brahe et al. 2015b)
	Human	Gut dysbiosis in post-menopausal women	(Ozaki et al. 2021)
Osteoporosis	Human	Intestinal microbiota as a target for the treatment of post-menopausal osteoporosis	(Xu et al. 2017)
	Human	Gut microbiota alteration in post-menopausal women and its association with osteoporosis	(Rettedal et al. 2021)
Inflammation	Human	Intervention induced variation in inflammatory markers in post-menopausal women	(Masala et al. 2020)
	Mice	Estrogen-mediated gut microbiome alterations influence sexual dimorphism in metabolic syndrome in mice	(Kaliannan et al. 2018)
	Human	Gut microbiota features and metabolic markers in postmenopausal women	(Brahe et al. 2015b)
	Human	Gut permeability, and inflammation across menopause transition	(Shieh et al. 2020)

Figure 3. Role of gut microbiota in the progression of type 2 diabetes among post-menopausal women.

Table 3. Prebiotics and their role in T2D management in post-menopausal women.

Prebiotic	Monosaccharide	Microbiota variation	Antidiabetic role	References
Resistant Dextrin	D-Glucopyranose	↑Peptostreptococcus ↑Fusobacterium ↑Bifidobacterium	Enhances SCFA production; specially butyrate production, Improves insulin resistance	(Aliasgharzadeh et al. 2015; Wang et al. 2020)
Oligofructose	Fructose and glucose	↑Bifidobacterium ↑Lactobacilli ↓Enterobacteriaceae	Improve glycemic condition, lipid profile, and antioxidant level	(Dehghan, Pourghassem Gargari, and Asghari Jafar-abadi 2014; Nie et al. 2019; Niness 1999)
Inulin	Fructose and glucose	↑Cyanobacteria ↑Bacteroides ↓Deferribacteres ↓Tenericutes	Improves fasting glucose level, body weight and blood lipid	(Wang et al. 2020; Yan et al. 2019)
Oligofructose enriched inulin	Fructose and glucose	↑Bifidobacterium	Improves fasting glucose level, limits IL-6 and TNF-α, while increases IL-10	(Dehghan, Pourghassem Gargari, and Asghari Jafar-abadi 2014)
Stachyose	2, α-D-galactose, α-D-glucose and fructose (Tetra-saccharide nature)	↑Phascolarctobacteria ↑Bilophila ↑Oscillospira ↑Turicibacter	Decreases serum LPS and expression of inflammatory cytokines i.e., Il-6 and TNF-α	(Liu et al. 2018; Yan et al. 2016)
Fructooligosaccharide	Fructose and glucose	↑Bifidobacterium ↑Lactobacilli	Improves body weight, antioxidant capacity and reducing hyperglycemia	(Gobinath et al. 2010; Nie et al. 2019)
Xylo-oligosaccharides	Xylose	↑Bifidobacterium ↑Lactobacilli	Improves body weight, antioxidant capacity and reducing hyperglycemia	(Gobinath et al. 2010; Wang et al. 2020)

Table 4. Probiotic strains used in previous studies and their roles against T2D (L. = Lactobacillus, B. =Bifidobacterium).

Probiotic strain	Model	Antidiabetic role	Reference
L. salivarius AP-32	Mice	Improves glycemic condition	(Hsieh et al. 2020)
L. gasseri BNR17, SBT2055	Mice/human	Improves blood glucose level, glucose sensitivity and obesity	(Sáez-Lara et al. 2016; Yun, Park, and Kang 2009)
L. plantarum MG4229, MG4296, MG5025 and CCFM0236	Human/Mice	α-glucosidase and α-amylase inhibitory, anti-oxidant activity	(Sáez-Lara et al. 2016; Won et al. 2021)
L. acidophilus KLDS1.1003, KLDS1.0901 and NCFM	Mice/Human	Improves gut-barrier function, glucose-lipid metabolism, and inflammation	(Andreasen et al. 2010; Yan et al. 2019)
L. rhamnosus GG	Human	Improves the glycemic condition	(Sanborn, Azcarate-Peril, and Gunstad 2020)
L. casei CCFM419, CCFM0412	Mice	Improves glucose level, insulin-resistance and inflammatory markers, higher SCFA	(Chen et al. 2014; Wang et al. 2017)
L. paracasei MG5012, NL41	Human/Mice	Improves blood glucose regulation and insulin resistance	(Won et al. 2021; Zeng et al. 2019)
L. reuteri ADR1, ADR3 and GL-104	Mice	Reduces insulin sensitivity and improves anti-oxidant activity	(Hsieh et al. 2018; Hsieh et al. 2020)
B. lactis HY8101	Mice	Improves insulin sensitivity, glucose and lipid metabolism	(Kim et al. 2014)
B. animalis 01	Mice	Improves hepatic insulin sensitivity	(Zhang et al. 2020)
B. longum DD98	Mice	Improves glucose level, regulates insulin and lipid metabolism	(Zhao et al. 2020)
B. pseudocatenulatum CECT 7765	Mice	Improves glucose tolerance and insulin resistance	(Cano et al. 2013)
Saccharomyces boulardii Biocodex	Mice	Improves body mass and inflammation	(Everard et al. 2014)
Clostridium butyricum CGMCC0313.1	Mice	Improves fasting blood glucose, glucose tolerance ad insulin resistance	(Jia et al. 2017)

Table 5. Synbiotic administration used in different T2D studies (L.=Lactobacillus, B.=Bifidobacterium, S. = Streptococcus).

Synbiotic	Model	Antidiabetic role	References
L. sporogenes and Inulin	Human	Decreases Triacylglycerol and VLDL	(Shakeri et al. 2014)
L. acidophilus and powdered Cinnamon	Human	Improves glycemic control and antioxidant status	(Mirmiranpour et al. 2020)
L. acidophilus ATCC 4357 with fructo-oligosaccharide and iso maltooligosaccharide	Rabbit	Reduction in blood glucose, urea and creatinine levels, Limits the abundance of E. coli	(Shafi et al. 2019)
L. fermentum and β-glucans from cauliflower mushroom	Mice	Improves dysbiosis	(Jeong et al. 2017)
L. acidophilus, B. bifidum, and fructooligosaccharide	Human	Improves glycemic condition	(Moroti et al. 2012)
L. sporogenes, inulin, and beta-carotene	Human	Improves triglyceride, insulin and antioxidant stress level	(Asemi et al. 2016)
L. casei, L. acidophilus, L. rhamnosus, L. bulgaricus, B. breve, B. longum, S. thermophilus, and fructooligosaccharide	Human	Improves serum insulin, insulin resistance and glycemic profile	(Raji Lahiji et al. 2021)
L. sporogenes, inulin, isomalt, Sorbitol,	Human	Improves serum insulin, and glucose homeostasis	(Asemi et al. 2014)
Bacillus coagulans, L. rhamnosus, L. acidophilus and fructo-oligosaccharide	Human	Improves fasting blood glucose level, and insulin resistance	(Velayati et al. 2021)

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