Determination of Abundance and Types of Gut Microbiota and Its Metagenomics Markers in Type 2 Diabetes Mellitus, Prediabetics and Normal Patients Visiting South C Medical Centre in Nairobi Kenya

Abstract

Type 2 Diabetes Mellitus (T2DM) has been progressing rapidly globally affects 347 Million people and one of the 10 leading cause of death. In Kenya prevalence of diabetes is projected to be 5.3% by 2025. There has been a myriad of factors responsible for unabated progression and organs damage and end result reflects the altered normal gut microbes. If altered microbiota is identified at earliest stage and treated then organs damage such as kidney, nerves and eyes can be avoided. This study aims at abundance of microbes and their metagenomics markers in diabetes in patients visiting South C Medical Centre Nairobi, Kenya. No metagenomics study on the role of the gut microbes in diabetes has been conducted in Kenyan population and there are no existing metagenomics markers of diabetes in Kenya. As such there is an existing knowledge gap on the type and abundance of gut microbiota and their metagenomics markers in diabetes, pre-diabetes and normal individual. This study fills the gap. This study adopted two basic objectives namely; type and abundance of bacteria colonizing the gut of diabetes, pre-diabetes and normal individual and their metagenomics markers based on the identified genera and abundance of bacteria. South C Medical Centre was chosen for study because of accessibility during pandemic period, no other hospital in Nairobi allowed for data collection. Total target population was 79 participants using Fisher’s Statistical formula and stratified random sampling in cross-sectional study. Random sampling from each strata 33 diabetes, 13 pre-diabetic and 33 normal individual were selected by random blood sugar measurement then fecal samples were collected from all 3 strata of persons and subjected to 16SRNA and V5-V6 Gene Sequencing. Reads were analyzed using MOTHUR Microbial Pipeline Analysis, alignments were done using SILVA Reference Microbial dataset. Alpha and Beta diversity were annotated by using rarefaction curve which show marked microbial dysbiosis in diabetic group of individual. High abundance of proteobacteria, low level of bacteriods and high firmicutes and bacteriod ratio were obtained by analysis. Significant abundance of Escherichia_shigella (P value = 0.000588, FDR=0.004706) was reported in diabetes. It was observed that high level of Escherichia_shigella in diabetes patients contributes to progression of diabetes disease by upregulating the inflammatory pathway and downregulating the insulin receptor gene and causing diabetic complication. This study recommends that if in diabetic patient implantation of gut microbiota from normal gut microbes individual is done then life-threatening complications can be mitigated and alleviated.