Abstract

In the last decade, the gastrointestinal microbiota has been recognised as being essential for health. Indeed, several publications have documented the suitability of probiotics, prebiotics, and symbiotics in the management of different diseases such as diabetes mellitus (DM). Advances in laboratory techniques have allowed the identification and characterisation of new biologically active molecules, referred to as “postbiotics”. Postbiotics are defined as functional bioactive compounds obtained from food-grade microorganisms that confer health benefits when administered in adequate amounts. They include cell structures, secreted molecules or metabolic by-products, and inanimate microorganisms. This heterogeneous group of molecules presents a broad range of mechanisms and may exhibit some advantages over traditional “biotics” such as probiotics and prebiotics. Owing to the growing incidence of DM worldwide and the implications of the microbiota in the disease progression, postbiotics appear to be good candidates as novel therapeutic targets. In the present review, we summarise the current knowledge about postbiotic compounds and their potential application in diabetes management. Additionally, we envision future perspectives on this topic. In summary, the results indicate that postbiotics hold promise as a potential novel therapeutic strategy for DM.

Highlights

  • Since ancient times, our forefathers were aware of the importance of fermented foods and fermenting microorganisms for well-being, and in particular for intestinal health [1]

  • The current literature available lacks enough studies for postbiotics in diabetes prevention or management, and we decided to include a few studies revolving around GABA and Extracellular Vesicles (EVs)

  • To the best of our knowledge, this is the first review attempting to summarise the evidence for postbiotics’ effects on diabetes mellitus (DM). Expertise in this area is still rather limited and there are inconsistencies between the results of the studies, the available literature suggests that this new entity in the -biotics field opens the door to new therapeutic and preventive approaches for DM and other metabolic diseases

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Summary

Introduction

Our forefathers were aware of the importance of fermented foods and fermenting microorganisms for well-being, and in particular for intestinal health [1]. The evidence for the role of the gastrointestinal microbiota (GM) in the host’s health is robust, and this is because of the endocrine, digestive, and defensive functions achieved by our microbes [2,3,4]. A large number of investigations have demonstrated that strategies aimed at modulating the GM composition or activity, for instance, employing probiotics or prebiotics supplementations, are useful for the restoration of the intestinal microbial environment and for the host’s health condition [9,10,11]. Probiotic refers to alive microorganisms that provide health benefits to the host through several mechanisms, including improvements of the intestinal barrier function, protection against pathogens, and the modulation of the immune response [12,13]. The most commonly used are species belonging to the genera Lactobacillus, Bifidobacterium, Streptococcus, and Lactococcus among

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