Gut microbiota and metabolic disease risk in youth.

The rapidly increasing global incidence of youth-onset diabetes is a critical public health concern. Earlier type 2 diabetes (T2D) onset in children and young people is characterized by faster progression and higher risk for complications. An area of expanding research is understanding how obesogenic environments modify the composition and function of the gut microbiota and, in turn, modulate host immune response as well as metabolism. The association between obesity and altered gut microbiota is complicated by hormonal changes during puberty and chronic inflammation that potentiates insulin resistance in multiple responsive tissues. This review examines the risk factors and mechanisms underlying T2D pathogenesis in children and young people and current evidence connecting gut microbiota to stages of disease progression and treatment opportunities. The potential for early intervention through modifications of the gut microbiota opens avenues to alleviate metabolic complications in critical developmental period and blunt the risk for early T2D onset.