Gut Microbiota and Their Metabolites as Modulators of Vascular Complications in Diabetes

Review Gut Microbiota and Their Metabolites as Modulators of Vascular Complications in Diabetes Meng Duan 1,2,3,†, Jielu Wen 1,2,†, Anning Chen 1,2,† and Sifan Chen 1,2,* 1 Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510000, China 2 Nanhai Translational Innovation Center of Precision Immunology, Sun Yat-Sen Memorial Hospital, Foshan 528200, China 3 Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510000, China * Correspondence: chensf26@mail.sysu.edu.cn † These authors contributed equally to this work. Received: 8 November 2024; Revised: 29 November 2024; Accepted: 24 December 2024; Published: 7 January 2025 Abstract: With the global rise in population and aging, along with the increasing burden of overweight and obesity, the prevalence of diabetes is expected to surge dramatically. Microvascular and macrovascular complications are the leading causes of death among patients with type 2 diabetes. Recent advancements have provided evidence suggesting that gut microbiota directly or indirectly regulate vascular function. This review focuses on the complex interactions between gut microbiota and its metabolites and vascular complications of diabetes. In particular, we highlight the novel therapeutic effects of interventions such as probiotics, dietary modifications, and fecal microbiota transplantation in improving gut microbiota composition and reducing the risk of vascular complications in diabetes. These findings not only provide new insights into the pathological mechanisms of diabetic vascular complications but also reveal ideas for guiding the formulation of future treatment strategies.