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World J Diabetes. Jul 15, 2026; 17(7): 118334
Published online Jul 15, 2026. doi: 10.4239/wjd.118334
Published online Jul 15, 2026. doi: 10.4239/wjd.118334
Gut-brain axis under attack: Links between diabetes, environmental toxicants, and neurodegeneration
Mostafa M Gouda, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310027, Zhejiang Province, China
Mostafa M Gouda, Department of Nutrition and Food Science, National Research Centre, Giza 12622, Egypt
Author contributions: Gouda MM was responsible for conceptualization, methodology, literature search, figure building, and writing the original draft of the manuscript.
AI contribution statement: The author takes full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. Grammarly was used solely for language polishing and typo correction. All Al-assisted outputs were carefully reviewed, validated, and approved by the author. No AI tools used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Mostafa M Gouda, PhD, Professor, College of Biosystems Engineering and Food Science, Zhejiang University, No. 866 Yuhangtang Road, Hangzhou 310027, Zhe
Received: December 30, 2025
Revised: February 14, 2026
Accepted: May 14, 2026
Published online: July 15, 2026
Processing time: 192 Days and 0.8 Hours
Revised: February 14, 2026
Accepted: May 14, 2026
Published online: July 15, 2026
Processing time: 192 Days and 0.8 Hours
Core Tip
Core Tip: Emerging evidence shows that when diabetes coincides with environmental metal exposure, it significantly impacts the gut-brain axis. Hyperglycemia and toxicants together lead to gut dysbiosis, intestinal barrier breakdown, and increased neuroinflammation. This results in worse cognitive and hippocampal damage than each factor alone. Specific microbiota changes link metabolic toxicity to brain dysfunction, suggesting the need for prevention through reduced exposure and better glycemic control.