Abstract

Diabesity refers to the co-occurrence of diabetes and obesity. Obesity and type 2 diabetes have been associated with unfavorable changes in the composition and functionality of the intestinal microbiota (dysbiosis), accompanying glucose and lipids metabolic alterations in the host. Moreover, an interrelationship seems to exist between the chronic low-grade inflammation occurring in obesity/diabetes, with mood disorders and early cognitive impairment, frequently associated with these pathologies. Focus on the intestinal microbiota, as a target for developing/evaluating strategies to fight against diabesity, constitutes a novel point of view in the management of this condition. Apart from calorie restricted diets, with proven low efficacy in the long-term, recent studies are focused on particular dietary components such as fatty acids, polyphenols, probiotics and prebiotics and their effect on diabesity, mediated by the intestinal microbiota. Medical treatments include the use of drugs with different mechanisms of action, most of them showing effects on the gut microbiota. The use of bariatric surgery is increasing in recent years for the treatment of severe obesity and favorable changes in microbiota composition and its metabolites have been evidenced linked to weight loss. Further studies are needed to elucidate whether changes in the microbiota are a cause or consequence of diabesity