Abstract:Type 2 diabetes (T2D) is a metabolic disorder characterized by the imbalance in the levels of blood glucose and lipid, threatening human health. Therefore, it is an urgent task to find a safe therapy with no side effects. Probiotics top the microbial therapies against T2D, which exert the anti-diabetes effect by regulating different tissues and metabolic pathways. To be specific, they modulate blood glucose by reducing chronic low-grade inflammation, alleviating oxidative stress, regulating intestinal flora, and increasing the content of short-chain fatty acids. They regulate blood lipids by enhancing the coprecipitation of cholesterol and bile salt and the transformation of cholesterol into fecal sterol in the gastrointestinal tract, reducing the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase in the liver, lowering the expression of cholesterol transporter, and regulating adipocytes. In this review, we summarized the current status of probiotics against diabetes and the anti-diabetes mechanisms based on intestinal microecology, hoping to lay a theoretical basis for developing hypoglycemic and lipid-lowering products with probiotics.