The Role of Diet and Physical Activity in Gut Microbiota Modulation in Type 2 Diabetes Management: A Systematic Review of Clinical Trials.

Nutr RevNov 12, 2026

Rita C S Soares, Flavia G Candido, Gabriela M Fraiz et al.

✦ AI-curated · Sources linked

In 30 seconds

This systematic review assessed clinical trials of dietary and physical activity interventions and gut microbiota in adults with type 2 diabetes or prediabetes. The review included 11 moderate-quality trials involving 319 participants; six were randomized, and all tested dietary interventions, with three also including physical activity. Most studies reported microbiome changes alongside improved diabetes prevention or control, including greater abundance of health-associated bacteria and improved microbial diversity. These changes were associated with better glycemic control and lower inflammation, but some effects were transient and varied by diet.

Key findings

  • The review included 11 moderate-quality trials (n = 319 participants), including 6 randomized controlled trials.
  • Most studies reported increased Faecalibacterium and Akkermansia, improved microbial diversity, and a reduced Bacillota/Bacteroidota ratio after lifestyle interventions.
  • Microbial changes correlated with better glycemic control and lower inflammation; some effects appeared transient and diet-dependent.

Why it matters

The findings suggest that gut microbiota changes may be one pathway linking lifestyle interventions with metabolic benefits in type 2 diabetes and prediabetes. They also highlight that dietary patterns may influence microbial composition and function, including short-chain fatty acid-producing bacteria. Understanding these links could help clarify how lifestyle interventions affect glucose metabolism and inflammation, while the evidence remains heterogeneous.

What to keep in mind

The evidence came from 11 moderate-quality trials with methodological heterogeneity; only six were randomized, and some reported effects were transient and diet-dependent.

Source

Published in Nutr Rev. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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AI-generated summaries may contain errors or omissions. Verify clinically important information with the original publication.

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