Modulation of gut microbiota by the herbal formulation Intestinal Flora Balance rescues pancreatic and intestinal microvascular dysfunction to alleviate type 2 diabetes mellitus

Background: The potential for microbial modulation to serve as both a therapeutic and prophylactic strategy against type 2 diabetes mellitus (T2DM)-induced microvasculopathy remains underexplored. We therefore compared the efficacy of the gut-centric herbal formulation Intestinal Flora Balance (IFB, BNFF™), when used for therapeutic reversal, synergistic rescue, or prophylactic protection.

Methods: A murine T2DM model was used to compare three arms, IFB monotherapy, IFB-metformin combination therapy, and IFB pretreatment administered prior to disease induction. Pancreatic and intestinal microcirculation was quantified using in vivo laser Doppler and fiber optic probes. Fecal microbiota composition was analyzed via 16S rRNA gene Sequencing.

Results: As a therapeutic agent, IFB monotherapy effectively lowered blood glucose and restored microvascular function by reversing diabetic gut dysbiosis. Combination with metformin, while not further improving glycemia, acted synergistically to provide superior rescue of pancreatic microcirculation, indicating complementary modes of action. Prophylactic administration of IFB conferred protection, preserving microbial homeostasis and significantly attenuating the onset of both hyperglycemia and microvascular damage. IFB enhanced the richness and diversity of the intestinal microbiome in T2DM mice and restored the Bacteroidetes/Firmicutes ratio.

Conclusions: By demonstrating that IFB ecologically restores the microbiome, in contrast to metformin's pharmacological modulation, our study provides a new framework for its use as a prophylactic, a restorative monotherapy, or a synergistic partner to build microcirculatory resilience.

Chinese herbal medicine; Gut microbiota; Microcirculation; Type 2 diabetes mellitus.