Abstract:
Disturbances in the gut microbiota have been associated with the onset and progression of Type 2 Diabetes Mellitus (T2DM). This study aims to the determination of Microbial Metagenomic Markers of Type 2 Diabetes Mellitus (T2DM) in Patients Visiting South C Health Centre in Nairobi Kenya. The study adopted three basic objectives, namely, types and abundance of Bacteria Colonizing the Gut of T2DM, Pre-Diabetic, and Non-Diabetic Patients Visiting South C Health Centre, T2DM metagenomics markers based on the identified genera and abundances of bacteria and correlation between metagenomic markers of T2DM, prediabetes and non-diabetic subjects and their clinical manifestations. The data used was collected from South C Medical Center in Nairobi, Kenya. The total target population was 79 persons in a cross-sectional metagenomic study which profiled the types and abundances of gut bacteria in 33 T2DM and 13 prediabetic Kenyan volunteers and compare these with the profiles of 33 Kenyans without diabetes. Postprandial random blood sugar (RBS) measurements were used to group the participants. Fecal samples were collected and subjected to 16S V5-V6 rRNA gene sequencing. Reads were analyzed using MOTHUR v. 1.39.1 and the SILVA reference dataset. Alpha and beta diversity and tests of significance were calculated using the MOTHUR Software. Samples from all the groups showed marked dysbiosis characterized by the high abundance of proteobacteria, low levels of bacteroidetes, and a high F/B ratio. The T2DM group had high levels of Firmicutes and Actinobacteria compared to the non-diabetic and prediabetic groups. Putative metagenomic markers of T2DM identified include elevated levels of Firmicutes and Actinobacteria, elevated F/B ratio, and high alpha diversity in T2DM (Chao 1 -value: 0.019888; [Kruskal-Wallis] statistic: 7.8353) and significant abundance of Escherichia shigella (p value=0.000588, FDR=0.004706). It was suggested that high levels of Escherichia Shigella in T2DM patients contribute to the progression of T2DM disease through the production of bacterial endotoxins leading to chronic systemic inflammation. High levels of opportunistic pathogens such as Escherichia Shigella, and Kluyvera in the T2DM group support the observation that monitoring the gut microbiome may be a useful strategy in monitoring and managing bacterial infections in the diabetic people.
