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<p>With the rising incidence of type 2 diabetes mellitus (T2DM) worldwide, the search for effective treatments has become an important direction of contemporary medical research. Bariatric metabolic surgery, as a new therapeutic approach, has made remarkable progress in improving T2DM in recent years. In this paper, we collected studies on the mechanisms by which metabolic surgery improves T2DM by altering the intestinal flora and its metabolites in the last 5 years, and systematically analysed the effects of different weight loss surgeries, such as gastric bypass and sleeve gastrectomy, on the composition of the intestinal flora. Then, the changes in the metabolites of the flora triggered by these surgeries and the possible downstream molecular mechanisms were explored. Although it has been revealed that the intestinal flora is altered by bacterial genera after metabolic surgery, the downstream mechanisms remain unclear. The aim of this review is to provide a new perspective for a deeper understanding of the microbiological mechanisms of metabolic surgery for T2DM and to provide a theoretical basis for future microbiome-based therapeutic strategies.</p>

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The Role of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Improving Type 2 Diabetes Through Modulation of Gut Microbiota and Metabolites

  • 期刊论文

  • 发表日期：

    2025年12月2日

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  • Zhi-Ming Wang,
  • Cheng-Jun He,
  • Jie Hou,
  • Si-Qi Zhang,
  • Hong-Bin Zhang,
  • Liang-Ping Wu

摘要

With the rising incidence of type 2 diabetes mellitus (T2DM) worldwide, the search for effective treatments has become an important direction of contemporary medical research. Bariatric metabolic surgery, as a new therapeutic approach, has made remarkable progress in improving T2DM in recent years. In this paper, we collected studies on the mechanisms by which metabolic surgery improves T2DM by altering the intestinal flora and its metabolites in the last 5 years, and systematically analysed the effects of different weight loss surgeries, such as gastric bypass and sleeve gastrectomy, on the composition of the intestinal flora. Then, the changes in the metabolites of the flora triggered by these surgeries and the possible downstream molecular mechanisms were explored. Although it has been revealed that the intestinal flora is altered by bacterial genera after metabolic surgery, the downstream mechanisms remain unclear. The aim of this review is to provide a new perspective for a deeper understanding of the microbiological mechanisms of metabolic surgery for T2DM and to provide a theoretical basis for future microbiome-based therapeutic strategies.