Table 1: Glucose-lowering agents and associated gut microbiota alterations.

Glucose-lowering agentGut microbiota alterationResearch subjects
Increased abundanceDecreased abundance

BiguanidesMetforminEscherichia [1, 12, 24]
Shigella [12]
Klebsiella [12]
Salmonella [12]
Adlercreutzia [30]
Clostridium cocleatum [43]
Akkermansia muciniphila [24, 43, 44]
Bifidobacterium adolescentis [24]
Intestinibacter [1, 24]
Clostridium [12]
Eubacterium [12]
T2DM patients [1, 24, 30]
Old women with T2DM [12]
HFD-fed mice [43, 44]

α-Glucosidase inhibitorsAcarboseBifidobacterium longum [23, 55]
Lactobacillus gasseri [23]
Lactobacillus [58]
Dialister [58]
Bacteroides plebeius [23]
Bacteroides dorei/vulgatus [23]
Clostridium bolteae [23]
Butyricicoccus [58]
Phascolarctobacterium [58]
Ruminococcus [58]
T2DM patients [23, 55]
Prediabetic patients [58]

PPAR-γ partial agonist (Chinese medicine)Danshensu Bingpian ZhiAkkermansia muciniphila [67]Helicobacter marmotae [67]HFD-fed mice [67]

DPP-4 inhibitorVildagliptinBacteroidetes [68]Prevotellaceae [68]
Ruminococcaceae [68]
HFD/STZ SD rats [68]
SitagliptinRoseburia [13]
Bifdobacterium [13]
Blautia [13]HF/HC-STZ SD rats [13]

T2DM: type 2 diabetes mellitus; HFD: high-fat diet; PPAR-γ: peroxisome proliferator-activated receptor γ; DPP-4: dipeptidyl peptidase-4; STZ: streptozotocin; HF/HC: high fat/high carbohydrate; SD rats: Sprague Dawley rats.