The gut microbiota in pre-diabetes and type-2 diabetes

The rising prevalence of type 2 diabetes (T2D) represents a major public health challenge with significant medical and societal implications. The gut metagenome has emerged as a potential contributor to the development of insulin resistance and T2D; however, its role remains insufficiently understood, partly due to disease heterogeneity and the high risk of cardiometabolic complications. Additionally, the confounding effects of antidiabetic treatments hinder the interpretation of associations between gut microbiota and T2D. To address these limitations, we profiled the gut microbiota of 1,831 treatment-naïve individuals from a Swedish cohort, all of whom provided fecal samples and underwent extensive cardiometabolic and multi-omics phenotyping. This study aims to determine whether alterations in the gut microbiome are detectable prior to disease onset and to stratify individuals based on clinical parameters, metabolite profiles, and microbiota composition, thereby enhancing our understanding of T2D heterogeneity and related co-morbidities.