Microbiota, Probiotics and Prebiotics: Their Role in T2D Management


Have you heard about the gut microbiota, probiotics, or prebiotics? It is undoubtedly an issue that has been gaining strength and interest among health professionals and society in general due to its important role in our health. Let’s talk about this wonderful symbiosis and its role in type 2 diabetes (T2D).

What is Microbiota?

Microbiota, previously known as intestinal flora, is the entire set of microorganisms (bacteria, viruses, fungi) that inhabit our body, they can be found in the mouth, genitals and more abundantly, in the large intestine.

Gut microbiota is involved in a variety of metabolic functions such as fermenting undigested carbohydrates (dietary fiber), absorbing electrolytes and minerals, modulating intestinal transit, synthesizing some micronutrients such as vitamin K and regulating the immune system.

The Link Between Type 2 Diabetes and Microbiota

Several studies carried out during the last decades have linked an imbalance of the microbiota with the development of metabolic diseases such as obesity and diabetes. It has been suggested that the interaction of environmental circumstances with the intestinal microbiota could cause an energy imbalance causing metabolic, neurocognitive and behavioral changes that favor the development of obesity and insulin resistance and later type 2 diabetes mellitus.

One of the medications that are usually used to treat type 2 diabetes mellitus is metformin and it has been shown to change the balance of the intestinal microbiota.

This does not mean that you should stop taking medications, but that you can counteract this situation by eating more fruits and vegetables, whole grains, moderating alcohol and tobacco consumption, and ingesting fermented foods, such as yogurt, occasionally.

Developing the Microbiota

There are natural ways to stimulate or develop this microbiota in our body. One of them is consuming probiotics.

Probiotics are living organisms that remain active in the intestine in a sufficient quantity to alter the host’s intestinal microbiota and can be found in yogurt, kombucha, kefir, among others.

You can also find prebiotics, which is a type of functional foods defined as indigestible food ingredients, (dietary fiber such as agave inulin, bran, guar gum, among others) that are used by the gut microbiota, stimulating its growth. When a food contains both probiotics and prebiotics, it is called symbiotic.

If you maintain a healthy diet with good consumption of fruits, vegetables and whole grains, you may not need to take a supplement routinely. Check with your healthcare provider. 

In case you have a treatment with antibiotics, you have had an intestinal infection, frequent diarrhea or constipation, or an episode of colitis or gastritis, a specialist should prescribe the most suitable probiotics for you and your situation. In the case of the use of metformin, the probiotics that can help maintain a good balance in the microbiota are lactobacilli and bifidobacteria, which can be found in pharmaceutical presentations but also in fermented foods as previously mentioned.

Taking Care of Microbiota

When living with type 2 diabetes, a fundamental part of treatment is diet. If our diet is balanced and correct, our microbiota will be balanced. If you do not take care of your diet, you will not have adequate management of your blood glucose (sugar), you will take much more medications and your microbiota will not be well. I recommend that you include vegetables, fruits, whole grains, yogurt, or some other fermented food in your diet, perform physical activity frequently and moderate your alcohol consumption. With all this, you will maintain healthy microbiota.

WRITTEN BY Brenda Estefanía Segovia Rodríguez, MS, Clinical Nutrition, POSTED 08/03/21, UPDATED 12/13/22

Brenda Estefanía Segovia Rodríguez has a bachelor's degree in nutrition and food science and a master's degree in clinical nutrition. She is a diabetes educator from the Universidad Iberoamericana León (Leon Ibero-american University). She has a Degree in dediatric nutrition and oncology nutrition. She is an active member of the Colegio de Nutriólogos de León (Leon College of Nutritionists). She has participated in workshops and camps with groups of young people living with type 1 diabetes mellitus. Currently she works at a private practice in Salamanca, Guanajuato. Find Brenda Segovia on her social networks, Facebook: nutrición funcional, Instagram: lncabrendasegovia or write her an email to nutrición_funcional@hotmail.com.