AUTHOR=Parekh Parth J. , Nayi Vipul R. , Johnson David A. , Vinik Aaron I. 

TITLE=The Role of Gut Microflora and the Cholinergic Anti-inflammatory Neuroendocrine System in Diabetes Mellitus

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 7 - 2016

YEAR=2016

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2016.00055

DOI=10.3389/fendo.2016.00055

ISSN=1664-2392

ABSTRACT=The obesity epidemic drastically impacted the state of health care in the United States. Paralleling this epidemic is the incidence of diabetes mellitus, with a notable shift  to much younger ages of onset. While central to the pathogenesis of diabetes associated with obesity is the role of inflammation attributed to “adiposopathy” it is now emerging that changes in sympathetic/parasympathetic balance regulated by the brain precedes changes in the inflammatory cascade. It has now been established that gut microflora may contribute significantly to the activation and inhibition of autonomic control and impact the set of the neuroinflammatory inhibitory reflex mediated by the cholinergic nervous system.  There has been a paradigm shift towards further investigating commensal bacteria in the gut/brain in the pathogenesis of obesity and diabetes mellitus and its complications, as dysbiosis is thought to play a significant if not pivotal role in diabetic associated disorders. This paper is intended to evaluate the role of intestinal dysbiosis in the pathogenesis of diabetes mellitus and examine the potential for restoration of balance via use of probiotics.