Type 2 diabetes {40000105}

Record Keys
Definition:	Type 2 diabetes
Class:	[ ]

Details
Other Terms:	T2D, adult-onset diabetes
Initialisation date:	2020-09-06

Links
Wickipedia Merck Manual

Meta Information
ICD:	[ ]
Category:	[ ]
MedDra ID:	10067585
MedDra Level:	pt

Notes

- The microbiome literature on T2D appears chaotic and concerns have been raised about variability of the results. Different taxa are reported to be associated with T2D in different studies. Furthermore, a recent large study observed that different microbes were found associated with the same metabolic outcomes in different geographical areas.

- Enterobacter cloacae B29 induced obesity and insulin resistance in germ-free mice. (3)

- PPI use is associated with reduced diversity of gut microbiome and consistent changes in the microbiota phenotype. (5)
- GIPR postbiotic agonist/antagonist may caus/prevent DM

Shared Notes

[1.34]
- Diabetes taking metformin had higher relative abundance of Akkermansia muciniphila, a microbiota known for mucin degradation, and several gut microbiota known for production of SCFAs, including Butyrivibrio, Bifidobacterium bifidum, Megasphaera, and an operational taxonomic unit of Prevotella.
[1.35]
- Duodenal hypercontractility observed during T2D leads to the genesis of aberrant signalling from the afferent nerves to the hypothalamus, contributing to systemic insulin resistance
- Enteric NO has the capacity to decrease duodenal contractions and restore the gut-brain axis, subsequently improving insulin sensitivity
- Prebiotic treatment (oligofructose) decreases duodenal hypercontractility by modulating ENS activity and an increase in the levels of an intestinal lipid, 12-hydroxyeicosatetraenoic acid (12-HETE).
- The mechanism of prebiotic action implies the presence of an enkephalin/mu-opioid receptor and proliferator-activated receptor γ signalling and a bioactive lipid, 12S-hydroxyeicosatetraenoic acid.
[1.31]
- Synbiotic yogurt-fed mice demonstrated lower fasting blood glucose (FBG) levels.
- The blood glucose rise during the meal tolerance test (MTT) is lower in the synbiotic yogurt-fed mice
- Insulin sensitivit in not impacted by Synbiotic yogurt-fed in mice.
- the abundances of fecal Proteobacteria and Enterobacteriacae correlate positively with FBG levels which increase the progression of diabetes in mice.
[1.36]
- Agonism of GIP receptor (GIPR) have glycemic effect.
[1.37]
- There is a significant correlation between gut microbiota dysbiosis and an elevated level of interleukin 6 (IL-6) in plasma samples of patients with type 2 diabetes (T2D)
[1.38]
- The feeding of the synbiotic yogurt significantly reduced the development of hyperglycemia (diabetes) in response to high-fat diet feeding and streptozotocin compared to milk-fed controls.
[1.39]
- The commonly used diabetes treatment Metformin increase Akkermansia spp. abundance, and to significantly improve glucose metabolism in high-fat diet fed mice while also increasing the number of mucin-producing goblet cells.
[1.40]
- Gut-targeted delayed-release NA but not NAM produced a significant increase in the abundance of Bacteroidetes.
- In the absence of systemic side effects, these favorable microbiome changes induced by microencapsulated delayed-release NA were associated with an improvement of biomarkers for systemic insulin sensitivity and metabolic inflammation.
[1.41]
- Genera of Bifidobacterium, Bacteroides, Faecalibacterium, Akkermansia and Roseburia were negatively associated with T2D, while the genera of Ruminococcus, Fusobacterium, and Blautia were positively associated with T2D.
- Bifidobacterium appears to be the most consistently supported by the literature genus containing microbes potentially protective against T2D
- there is a negative association between specific species such as B. adolescentis, B. bifidum, B. pseudocatenulatum, B. longum, B. dentium and disease in patients treated with metformin or after undergoing gastric bypass surgery
[1.42]
- Parabacteroides is positively associated with diabetes.
- In a mouse model oral administration of Akkermansia activated toll-like receptor 2, increased the expression of epithelial tight-junction proteins, and reversed high-fat diet-induced insulin resistance
- Akkermansia was the only genus that was underrepresented in patients with elevated HbA1c
- Anaerostipes is positively associated with type 2 diabetes. Similarly, in studies of type 1 diabetes and gestational diabetes, Parabacteroides was elevated compared to healthy controls.
[1.43]
- High fiber diet > Prevotella copri > improve glucose and insulin tolerance.
[1.33]
- TMA and subsequent conversion to TMAO by host FMO3 is related to T2DM pathogenesis and comorbidities.
- Mice with selective hepatic insulin resistance have elevated levels of circulating TMAO.
- Dietary supplementation with TMAO can exacerbate glucose intolerance in high-fat–fed mice.
- High concentrations TMAO directly binds to and activates PERK, a key effector of the unfolded protein response in the liver, promoting hyperglycemia and metabolic dysfunction
- TGR5, unlike the nuclear receptors discussed above, is a GPCR, expressed by digestive, immune, and adipose tissues where it is preferentially activated by LCA and DCA.
- In the gut, TGR5 activation leads to secretion of GLP-1 and PYY, thereby having beneficial effects on insulin secretion and satiety.
- TGR5 knockout in macrophages and myeloid-lineage cells was found to exacerbate adipose tissue inflammation and insulin resistance, suggesting a protective role in T2DM pathogenesis
- Among obese individuals with at least 1 comorbidity the production of indole, IPA, indole 3-acetic acid, and indole 3-carboxaldehyde is decreased versus lean individuals, suggesting that a change in meta-organismal tryptophan metabolism may occur prior to T2DM onset and thus may contribute to its development.
- The microbial product of histidine metabolism, imidazole propionate (ImP), was recently shown to be directly involved in insulin resistance.
- Exogenous ImP showed worsened glucose tolerance, increased gluconeogenic enzyme expression, increased S6 kinase phosphorylation, and impaired insulin signaling in multiple tissues on a normal chow diet. In vitro ImP also impaired insulin-stimulated phosphorylation of protein kinase B.
- ImP activates mTORC1.
- In diabetic mice, the administration of a synthetic FXR agonist markedly reduced plasma glucose, triglycerides, free fatty acids, and cholesterol as well as hepatic steatosis.
- Conversely, intestine-specific knockout of FXR in mice was shown to reduce insulin resistance and hepatic triglyceride accumulation
- Four G-protein coupled receptors (GPCRs) for SCFAs have been identified: GPR41 (free fatty acid receptor 3), GPR43 (free fatty acid receptor 2), GPR109a, and olfactory receptor 78.
- Of the 4 receptors, the 2 most directly implicated in T2DM are GPR41 and GPR43.
- GPR41 recognizes all 3 SCFAs but is activated 10-fold less by acetate and is reported to be expressed in adipose tissue, the gut by intestinal L-cells, the nervous system, and the kidney.
- GPR41 resulted in increased gut motility via reduced peptide YY (PYY) secretion, which resulted in decreased intestinal absorption of nutrients, implicating a role in food consumption.
- GPR41 activation stimulate energy expenditure, thereby having a protective effect against T2DM onset.
In the kidney, GPR41 seems to play a role in decreasing blood pressure, which could play a protective role againstT2DM-mediated kidney damage in later disease stages.
- Treatment with SCFAs in both rodent models and humans improves T2DM phenotypes
[1.44]
- Lachnospira contribute to diabetes in obese mice and is enriched in obese children
[1.45]
- Individuals with T2D have lower gut microbiome alpha diversity compared with healthy controls and they also show impaired SCFA butyrate production,12 modifications in incretin secretion, reducing intestinal permeability leading to metabolic endotoxemia (increased LPS in blood) that is linked to increasing metabolic inflammation and insulin resistance induced by high-fat diet.
[1.54]
- Lactobacillus > positively correlated with fasting glucose and HbA1c levels > increased insulin resistance.
- Clostridium > negative correlation with with fasting glucose and HbA1c levels > decreased insulin resistance.
[1.55]
- Akkermansia muciniphila is a mucin degraders, an important role in the preservation of the integrity of the gut mucus layer, thus
limiting the risk of systemic inflammation.
- Dietary polyphenols such as anthocyanins (ACNs) and proanthocyanidins (PACs) protect against metabolic syndrome.
- Supplementation of high-fat diets with ACNs or PACs has been shown to suppress the expression of genes involved in fatty acid and triacylglycerol synthesis, the regulation of lipogenesis and cholesterol biosynthesis, and the assembly of very low density
lipoproteins.
- ACNs and PACs have also been argued to stem the development of insulin resistance by increasing insulin signaling, glycogen accumulation and adiponectin secretion in the presence of free fatty acids.
A. muciniphila abundance has been linked to reduced weight gain, adiposity, insulin resistance, and/or inflammatory markers in many contexts, including during pregnancy.
[1.56]
- Faecalibacterium prausnitzii, an indicator of inflammation, shows a decreased abundance in diabetes and obese persons.

Increased abundance of

‐ Acidaminococcus Faeces ‎Human [1.1]

‐ Acinetobacter Conjunctival swab ‎Human [1.2]

‐ Acinetobacter Urine ‎Human [1.3]

‐ Actinobacteria Faeces ‎Human [1.4]

‐ Actinomyces georgiae Subgingival plaque ‎Human [1.5]

‐ Actinomyces israelii Subgingival plaque ‎Human [1.5]

‐ Actinomyces naeslundii Subgingival plaque ‎Human [1.5]

‐ Actinomyces viscosus Subgingival plaque ‎Human [1.5]

‐ Actinomyces Subgingival plaque ‎Human [1.6]

‐ Actinomyces Urine ‎Human [1.3]

‐ Actinotalea Blood ‎Human [1.7]

‐ Aggregatibacter actinomycetemcomitans Subgingival plaque ‎Human [1.5]

‐ Akkermansia muciniphila ‎Curative

‐ Akkermansia muciniphila Faeces ‎Human [1.8]

‐ Alishewanella Blood ‎Human [1.7]

‐ Alistipes Faeces ‎Human [1.4]

‐ Alistipes Urine ‎Human [1.9]

‐ Bacteroides caccae Faeces ‎Human [1.10]

‐ Bacteroides coprophilus Urine ‎Human [1.3]

‐ Bacteroides finegoldii Faeces ‎Human [1.10]

‐ Bacteroides intestinalis Faeces ‎Human [1.8]

‐ Bacteroides Conjunctival swab ‎Human [1.11]

‐ Bacteroides Faeces ‎Human [1.4]

‐ Bifidobacteriaceae Faeces ‎Human [1.4]

‐ Bifidobacterium Oral swab ‎Human [1.12]

‐ Brevibacterium Foot swab ‎Human [1.13]

‐ Brevibacterium Urine ‎Human [1.3]

‐ Burkholderia Conjunctival swab ‎Human [1.2]

‐ Campylobacter gracilis Subgingival plaque ‎Human [1.5]

‐ Campylobacter rectus Subgingival plaque ‎Human [1.5]

‐ Campylobacter showae Subgingival plaque ‎Human [1.5]

‐ Capnocytophaga ochracea Subgingival plaque ‎Human [1.5]

‐ Capnocytophaga sputigena Subgingival plaque ‎Human [1.5]

‐ Chryseobacterium Conjunctival swab ‎Human [1.11]

‐ Clostridium boltae Faeces ‎Human [1.8]

‐ Clostridium bolteae

‐ Clostridium clostridioforme Faeces ‎Human [1.14]

‐ Clostridium hathewayi Faeces ‎Human [1.8]

‐ Clostridium ramosum Faeces ‎Human [1.8]

‐ Clostridium symbiosum Faeces ‎Human [1.8]

‐ Collinsella intestinalis Faeces ‎Human [1.10]

‐ Comamonas Foot swab ‎Human [1.13]

‐ Corynebacterium matruchotii Subgingival plaque ‎Human [1.5]

‐ Corynebacterium Foot swab ‎Human [1.13]

‐ Corynebacterium Subgingival plaque ‎Human [1.6]

‐ Corynebacterium Urine ‎Human [1.3]

‐ Deinococcus Urine ‎Human [1.9]

‐ Delftia Urine ‎Human [1.9]

‐ Dermacoccus Foot swab ‎Human [1.13]

‐ Desulfovibrio piger Faeces ‎Human [1.15]

‐ Dialister Subgingival plaque ‎Human [1.16]

‐ Dorea Faeces ‎Human [1.17]

‐ Eggerthella lenta Faeces ‎Human [1.8]

‐ Eggerthella Faeces ‎Human [1.10]

‐ Enterobacter cloacae B29 ‎Causal

‐ Enterococcus Urine ‎Human [1.9]

‐ Epstein-Barr virus Saliva ‎Human [1.18]

‐ Escherichia coli Faeces ‎Human [1.8]

‐ Escherichia Faeces ‎Human [1.1]

‐ Escherichia Tissue biopsie ‎Human [1.19]

‐ Eubacterium biforme Urine ‎Human [1.3]

‐ Eubacterium saburreum Subgingival plaque ‎Human [1.5]

‐ Eubacterium Faeces ‎Human [1.15]

‐ Finegoldia Urine ‎Human [1.3]

‐ Fusobacterium nucleatum Subgingival plaque ‎Human [1.5]

‐ Fusobacterium periodonticum Subgingival plaque ‎Human [1.5]

‐ Fusobacterium Faeces ‎Human [1.17]

‐ Gemella Urine ‎Human [1.3]

‐ Haemophilus Buccal swab ‎Human [1.20]

‐ Halomonas Urine ‎Human [1.3]

‐ Human papillomavirus Saliva ‎Human [1.18]

‐ Klebsiella Urine ‎Human [1.9]

‐ Kocuria Foot swab ‎Human [1.13]

‐ Lachnospiraceae Faeces ‎Human [1.8]

‐ Lactobacillus acidophilus Faeces ‎Human [1.21]

‐ Lactobacillus bulgaricus Faeces ‎Human [1.21]

‐ Lactobacillus gasseri Faeces ‎Human [1.14]

‐ Lactobacillus plantarum Faeces ‎Human [1.22]

‐ Lactobacillus reuteri Faeces ‎Human [1.22]

‐ Lactobacillus rhamnosus Faeces ‎Human [1.21]

‐ Lactobacillus ruminis Faeces ‎Human [1.23]

‐ Lactobacillus salivarius Faeces ‎Human [1.14]

‐ Lactobacillus Faeces ‎Human [1.22]

‐ Lactobacillus Tissue biopsie ‎Human [1.19]

‐ Lactobacillus Urine ‎Human [1.3]

‐ Leptotrichia Subgingival plaque ‎Human [1.6]

‐ Megasphaera elsdenii Faeces ‎Human [1.10]

‐ Megasphaera Faeces ‎Human [1.1]

‐ Methanobrevibacter Faeces ‎Human [1.23]

‐ Microbacterium Urine ‎Human [1.3]

‐ Micrococcus Conjunctival swab ‎Human [1.2]

‐ Micrococcus Foot swab ‎Human [1.13]

‐ Micrococcus Urine ‎Human [1.9]

‐ Neisseria mucosa Subgingival plaque ‎Human [1.5]

‐ Neisseria Buccal swab ‎Human [1.20]

‐ Neisseria Subgingival plaque ‎Human [1.24]

‐ Olsenella Subgingival plaque ‎Human [1.6]

‐ Parabacteroides distasonis Urine ‎Human [1.3]

‐ Parabacteroides Faeces ‎Human [1.8]

‐ Parvimonas micra Subgingival plaque ‎Human [1.5]

‐ Pedobacter Conjunctival swab ‎Human [1.11]

‐ Peptostreptococcus Faeces ‎Human [1.15]

‐ Prevotella Conjunctival swab ‎Human [1.11]

‐ Prevotella Faeces ‎Human [1.25]

‐ Prevotella Urine ‎Human [1.3]

‐ Pseudoclavibacter Blood ‎Human [1.7]

‐ Pseudomonas Buccal swab ‎Human [1.20]

‐ Rheinheimera Conjunctival swab ‎Human [1.2]

‐ Roseburia Faeces ‎Human [1.25]

‐ Rubellimicrobium Urine ‎Human [1.9]

‐ Ruminococcaceae Conjunctival swab ‎Human [1.11]

‐ Ruminococcus gnavus Urine ‎Human [1.3]

‐ Sediminibacterium Blood ‎Human [1.7]

‐ Selenomonas artemidis Subgingival plaque ‎Human [1.5]

‐ Selenomonas Subgingival plaque ‎Human [1.6]

‐ Shigella Faeces ‎Human [1.26]

‐ Shigella Urine ‎Human [1.9]

‐ Shuttleworthia Urine ‎Human [1.3]

‐ Sphingomonas Foot swab ‎Human [1.13]

‐ Staphylococcus Foot swab ‎Human [1.13]

‐ Staphylococcus Urine ‎Human [1.3]

‐ Stenotrophomonas Urine ‎Human [1.9]

‐ Streptococcaceae Tissue biopsie ‎Human [1.27]

‐ Streptococcus anginosus Subgingival plaque ‎Human [1.5]

‐ Streptococcus constellatus Subgingival plaque ‎Human [1.5]

‐ Streptococcus gordonii Subgingival plaque ‎Human [1.5]

‐ Streptococcus intermedius Subgingival plaque ‎Human [1.5]

‐ Streptococcus mutans Faeces ‎Human [1.14]

‐ Streptococcus salivarius Faeces ‎Human [1.10]

‐ Streptococcus sanguinis Subgingival plaque ‎Human [1.5]

‐ Streptococcus Buccal swab ‎Human [1.20]

‐ Streptococcus Faeces ‎Human [1.17]

‐ Streptococcus Urine ‎Human [1.3]

‐ Subdoligranulum Faeces ‎Human [1.8]

‐ Tannerella Subgingival plaque ‎Human [1.6]

‐ Veillonella parvula Subgingival plaque ‎Human [1.5]

‐ Weeksella Conjunctival swab ‎Human [1.11]

Decreased abundance of

‐ Acinetobacter Buccal swab ‎Human [1.20]

‐ Acinetobacter Conjunctival swab ‎Human [1.11]

‐ Actinomycetales Foot swab ‎Human [1.13]

‐ Adlercreutzia Faeces ‎Human [1.15]

‐ Aggregatibacter Subgingival plaque ‎Human [1.6]

‐ Akkermansia muciniphila Faeces ‎Human [1.10]

‐ Akkermansia muciniphila Urine ‎Human [1.3]

‐ Akkermansia Faeces ‎Human [1.17]

‐ Anaerostipes Faeces ‎Human [1.15]

‐ Anaerostipes Urine ‎Human [1.3]

‐ Aquabacterium Blood ‎Human [1.7]

‐ Arcanobacterium Urine ‎Human [1.9]

‐ Arcobacter Urine ‎Human [1.9]

‐ Atopobium Faeces ‎Human [1.22]

‐ Bacteriodes uniformis Urine ‎Human [1.3]

‐ Bacteroides ovatus Urine ‎Human [1.3]

‐ Bacteroides vulgatus ‎Causal

‐ Bifidobacterium adolescentis Faeces ‎Human [1.21]

‐ Bifidobacterium ‎Causal

‐ Bifidobacterium Faeces ‎Human [1.28]

‐ Bifidobacterium Tissue biopsie ‎Human [1.19]

‐ Bilophila Urine ‎Human [1.3]

‐ Blautia coccoides Faeces ‎Human [1.22]

‐ Bradyrhizobiaceae Conjunctival swab ‎Human [1.2]

‐ Butyricimonas Urine ‎Human [1.3]

‐ Campylobacter Subgingival plaque ‎Human [1.6]

‐ Capnocytophaga ochracea Subgingival plaque ‎Human [1.24]

‐ Cardiobacterium valvarum Subgingival plaque ‎Human [1.24]

‐ Cellulosilyticum ruminicola Faeces ‎Human [1.15]

‐ Clostridium bartletti Faeces ‎Human [1.10]

‐ Clostridium beijerinckii Faeces ‎Human [1.14]

‐ Clostridium botulinum Faeces ‎Human [1.14]

‐ Clostridium butyricum Faeces ‎Human [1.15]

‐ Clostridium leptum Faeces ‎Human [1.29]

‐ Clostridium paraputrificum Faeces ‎Human [1.15]

‐ Clostridium thermocellum Faeces ‎Human [1.14]

‐ Collinsella Faeces ‎Human [1.15]

‐ Coprococcus Urine ‎Human [1.3]

‐ Corynebacterium matruchotii Subgingival plaque ‎Human [1.24]

‐ Desulfurispirillum indicum Faeces ‎Human [1.14]

‐ Dialister invisus Faeces ‎Human [1.10]

‐ Dorea Urine ‎Human [1.3]

‐ Epulopiscium Faeces ‎Human [1.15]

‐ Erysipelotrichaceae Faeces ‎Human [1.8]

‐ Eubacterium rectale Faeces ‎Human [1.8]

‐ Eubacterium Faeces ‎Human [1.8]

‐ Faecalibacterium prausnitzii ‎Causal

‐ Faecalibacterium prausnitzii Faeces ‎Human [1.8]

‐ Faecalibacterium Faeces ‎Human [1.17]

‐ Faecalibacterium Urine ‎Human [1.3]

‐ Filifactor Subgingival plaque ‎Human [1.16]

‐ Fusobacterium Subgingival plaque ‎Human [1.6]

‐ Gallicola Urine ‎Human [1.9]

‐ Haemophilus parainfluenzae Faeces ‎Human [1.8]

‐ Haemophilus Subgingival plaque ‎Human [1.6]

‐ Klebsiella Urine ‎Human [1.3]

‐ Kocuria Urine ‎Human [1.9]

‐ Lachnobacterium Urine ‎Human [1.3]

‐ Lachnospiraceae Faeces ‎Human [1.23]

‐ Lachnospira Urine ‎Human [1.3]

‐ Leptotrichiaceae Subgingival plaque ‎Human [1.24]

‐ Mannheimia Subgingival plaque ‎Human [1.6]

‐ Megamonas Urine ‎Human [1.3]

‐ Methanosphaera Faeces ‎Human [1.23]

‐ Moraxellaceae Conjunctival swab ‎Human [1.11]

‐ Murdochiella Urine ‎Human [1.9]

‐ Neisseria flavescens Subgingival plaque ‎Human [1.24]

‐ Neisseria Subgingival plaque ‎Human [1.6]

‐ Novosphingobium Conjunctival swab ‎Human [1.2]

‐ Odoribacter Urine ‎Human [1.3]

‐ Oscillospira Urine ‎Human [1.3]

‐ Parabacteroides Faeces ‎Human [1.17]

‐ Paraprevotella Urine ‎Human [1.3]

‐ Pediococcus Faeces ‎Human [1.15]

‐ Peptoniphilus Urine ‎Human [1.9]

‐ Phascolarctobacterium Urine ‎Human [1.3]

‐ Prevotella copri Faeces ‎Human [1.23]

‐ Prevotella loescheii Subgingival plaque ‎Human [1.24]

‐ Prevotella Faeces ‎Human [1.22]

‐ Propionibacterium Foot swab ‎Human [1.13]

‐ Proteobacteria Conjunctival swab ‎Human [1.11]

‐ Pseudomonas Conjunctival swab ‎Human [1.11]

‐ Pseudomonas Urine ‎Human [1.3]

‐ Pseudonocardia Blood ‎Human [1.7]

‐ Pyramidobacter piscolens Faeces ‎Human [1.14]

‐ Roseburia hominis Faeces ‎Human [1.10]

‐ Roseburia intestinalis Faeces ‎Human [1.8]

‐ Roseburia inulinivorans Faeces ‎Human [1.8]

‐ Rubrobacter Foot swab ‎Human [1.13]

‐ Ruminococcus lactaris Faeces ‎Human [1.15]

‐ Ruminococcus productus Urine ‎Human [1.3]

‐ Shewanella algae Urine ‎Human [1.3]

‐ Solitalea Urine ‎Human [1.9]

‐ Staphylococcus Conjunctival swab ‎Human [1.2]

‐ Staphylococcus Foot swab ‎Human [1.13]

‐ Streptococcus Foot swab ‎Human [1.13]

‐ Streptophyta Conjunctival swab ‎Human [1.2]

‐ Sutterella Faeces ‎Human [1.1]

‐ Sutterella Urine ‎Human [1.3]

‐ Terrisporobacter glycolicus Faeces ‎Human [1.15]

‐ Xanthomonas Blood ‎Human [1.7]

References

(7) Gastrointestinal microbiota in type 2 diabetes [Abstract] [2014]

(5) hRegular use of PPIs linked with increased risk of type 2 diabetes, study suggests [Method] [2020]

(2) Qin J, Li Y, Cai Z, Li S, Zhu J, Zhang F et al. (2012). A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature 490: 55?60. [Research] [2012]

(3) Fei N, Zhao L. (2013). An opportunistic pathogen isolated from the gut of an obese human causes obesity in germfree mice. ISME J 7: 880?884. [Research] [2013]

Type 2 diabetes {40000105}

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Details

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Notes

Shared Notes

Common References