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World J Diabetes. Sep 15, 2026; 17(9): 122293
Published online Sep 15, 2026. doi: 10.4239/wjd.122293
Published online Sep 15, 2026. doi: 10.4239/wjd.122293
Targeting gut microbiota: Potential mechanisms in the pathogenesis of type 2 diabetes mellitus and emerging translational intervention strategies
Fu-Jian Xie, Li-Ming Bi, Department of Traditional Chinese Medicine Classics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi 214071, Jiangsu Province, China
Miao Zhang, Wan-Ting Li, Department of Stomatology, Shanghai Tenth People’s Hospital, Tongji University Cancer Center, Tongji University School of Medicine, Shanghai 200072, China
Wan-Ting Li, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical Uni
Wei-Ye Zhou, Hai-Bei Ma, School of Public Health and Emergency Management, Southern Uni
Yu Xu, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Co-first authors: Fu-Jian Xie and Miao Zhang.
Co-corresponding authors: Yu Xu and Li-Ming Bi.
Author contributions: Xie FJ and Zhang M were responsible for conceptualization, validation, writing-original draft, and equally contributed as co-first authors; Li WT was responsible for investigation, formal analysis, data curation, and visualization; Zhou WY and Ma HB were responsible for resources and project administration; Xu Y and Bi LM were responsible for supervision, writing-review and editing, and equally contributed as co-corresponding authors; all authors have read and agreed to the published version of the manuscript.
AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by Wuxi “Double Hundred” Young and Middle-aged Medical Top Talents Program, No. BJ2023065; and Jiangsu Provincial Administration of Traditional Chinese Medicine, No. ZZYB21.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Li-Ming Bi, MD, Professor, Department of Traditional Chinese Medicine Classics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, No. 8 Zhongnan West Road, Binhu District, Wuxi 214071, Jiangsu Province, China.
Received: April 17, 2026
Revised: July 1, 2026
Accepted: July 28, 2026
Published online: September 15, 2026
Processing time: 138 Days and 11.5 Hours
Revised: July 1, 2026
Accepted: July 28, 2026
Published online: September 15, 2026
Processing time: 138 Days and 11.5 Hours
Core Tip
Core Tip: Increasing evidence indicates that gut microbiota plays a critical role in the development of type 2 diabetes mellitus (T2DM). Unlike previous reviews that primarily focus on microbial compositional alterations, this review highlights that functional dysregulation of the gut microbiota is the central driver of T2DM pathogenesis. We propose an integrated metabolic-immune-barrier-endocrine framework linking microbial metabolites, inflammation, intestinal barrier dysfunction, and endocrine signaling to glucose dysregulation. We further summarize emerging microbiota-targeted interventions and their translational potential for personalized T2DM management.