POTENTIAL ROLE OF MICROBIOTA–GUT–BRAIN AXIS DYSFUNCTION IN PROCRASTINATION-LIKE BEHAVIOR IN DIABETES

Main Article Content

Happy Isibor
Celestine Ogheneruro Akpovwre

Abstract

Procrastination, the voluntary delay of intended actions despite anticipated negative consequences, represents a significant behavioral barrier to effective diabetes self-management. While traditionally conceptualized as a psychological or personality-related trait, emerging evidence suggests that procrastination-like behaviors in diabetes may have neurobiological underpinnings rooted in the pathophysiology of the disease itself. This review synthesizes current evidence linking microbiota–gut–brain axis (MGBA) dysfunction to the triad of dopaminergic signaling deficits, neuroinflammation, and cognitive impairment that collectively may drive procrastination-like behaviors in diabetic patients. We proposed a mechanistic framework whereby diabetes-induced gut dysbiosis triggers systemic and neuroinflammation via microbial metabolite dysregulation and increased intestinal permeability, which in turn disrupts central dopaminergic reward circuitry and impairs executive functions, particularly cognitive flexibility, inhibition, and planning. These converging pathologies may contribute to a neurobehavioral state characterized by reduced motivational drive, impaired self-regulation, and diminished capacity for goal-directed behavior, manifesting clinically as health-related procrastination. Understanding this axis offers novel therapeutic opportunities targeting the gut microbiome, inflammatory pathways, and dopaminergic signaling to improve behavioral outcomes in diabetes care.

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Original Research Article

How to Cite

Isibor, H., & Akpovwre, C. O. (2026). POTENTIAL ROLE OF MICROBIOTA–GUT–BRAIN AXIS DYSFUNCTION IN PROCRASTINATION-LIKE BEHAVIOR IN DIABETES . Frontline Professionals Journal, 3(8), 206-215. https://doi.org/10.60787/fpj.vol3no8.136

References

Abildinova, G. Z., Benberin, V. V., Vochshenkova, T. A., Afshar, A., Mussin, N. M., Kaliyev, A. A., ... & Tamadon, A. (2024). The gut-brain-metabolic axis: exploring the role of microbiota in insulin resistance and cognitive function. Frontiers in Microbiology, 15, 1463958.

Ahmed, A., Ali, Z., Abid, M., Niaz, H., & Ali, U. (2025). Neurocognitive and Behavioral Outcomes in Patients With Insulin Resistance and Type 2 Diabetes: A Systematic Review of Recent Evidence. Cureus, 17(9), e92867.

Alasousi, D., Braysh, K., D’souza, L., Islam, S., Alhawaj, F., Nizam, R., ... & Al-Onaizi, M. (2026). Immunometabolic dysregulation drives selective executive cognitive dysfunction in male db/db mice. Neurobiology of Disease, 107376.

Amalia, R., Indreswari, H., Hambali, I. M., Setiyowati, A. J., Hidayah, N., Aditya, R. S., ... & Almutairi, R. I. (2026). Procrastination as a neurocognitive syndrome: evidence from VBM, RSFC, and Temporal activation patterns in executive and Default-Mode networks. Brain Imaging and Behavior, 20(3), 81.

Anih, D. C., AK, A., MA, A., & KC, U. (2025). Biochemically active metabolites of gut bacteria: Their influence on host metabolism, neurotransmission, and immunity. Sci. Int, 13, 46-57.

Buck, J. (2025). The Effects of Multi-Modal Exercise Programs on Executive Function and Working Memory on Individuals With Diabetes Mellitus Over the Age of 50: A Meta-Analysis (Doctoral dissertation, California State University, Fresno).

Chen, X., Huang, Y., & Xiong, X. (2025). Mechanisms underlying cognitive impairment and management strategies in type 2 diabetes. Frontiers in Endocrinology, 16, 1655768.

Chen, Y., Jin, D., Han, X., Liu, X., Liu, Y., & Wang, L. (2026). Gut microbiota in type 2 diabetes mellitus: mechanistic links between dysbiosis, insulin resistance, and chronic low-grade inflammation. Frontiers in Endocrinology, 17, 1856667.

Di Vincenzo, F., Del Gaudio, A., Petito, V., Lopetuso, L. R., & Scaldaferri, F. (2024). Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review. Internal and emergency medicine, 19(2), 275-293.

Erhunmwunse, R., Ogbodo, E., & Muoneke, G. (2025). Complications associated with type 2 diabetes mellitus, pathophysiology, diagnosis and management: A concise review of current literature. Saudi J. Biomed. Res, 10, 201-244.

Far, Z. B., Moghaddam, M. B., & Afshari, F. (2025). The Relationship between Health-Related Procrastination, Personality Type, and Quality of Life in Nurses.

Felger, J. C., & Treadway, M. T. (2017). Inflammation effects on motivation and motor activity: role of dopamine. Neuropsychopharmacology, 42(1), 216-241.

Ghosh-Swaby, O. R. (2025). Combatting Cognitive Decline in Obesity and Diabetes: The Use of Lifestyle and Drug Interventions That Target Neuroplasticity (Doctoral dissertation).

Guo, X., & Russo, S. J. (2026). Cross-Organ Neuroimmunology of Behavior. Annual review of immunology, 44.

Gupta, T., Kumar, S., Singh, T. G., & Singh, R. (2026). The metabolic roots of memory loss: interlinking the Diabetes-Alzheimer’s hypothesis. Metabolic Brain Disease, 41(1), 64.

Hallab, A., Health, T., Study, A. B., Team, S., O'Bryant, S. E., Yaffe, K., ... & Vig, R. (2025). Mediating role of Interleukin-6 in the predictive association of diabetes with Hippocampus atrophy, Amyloid, Tau, and Neurofilament pathology at pre-clinical stages of diabetes-related cognitive impairment. Brain, Behavior, & Immunity-Health, 47, 101031.

Hu, Y., Tang, Y., Li, W., Zheng, D., Jin, Y., Fan, Q., ... & Chen, Z. (2026). Shared neurogenetic architecture links adolescent neurodevelopmental deviations to adult psychopathological procrastination. Molecular Psychiatry, 1-15.

Katsigianni, S., & Koutsouraki, E. (2026). Gut Microbiota Dysbiosis and Neuroinflammation in Alzheimer’s Disease: a Systematic Review of Mechanistic Insights. Molecular neurobiology, 63(1), 623.

Kleinridders, A., & Pothos, E. N. (2019). Impact of brain insulin signaling on dopamine function, food intake, reward, and emotional behavior. Current nutrition reports, 8(2), 83-91.

Kontogianni, A., Yang, H., & Chen, W. (2026). Brain insulin resistance and neuropsychiatric symptoms in Alzheimer’s disease: A role for dopamine signaling. Neural Regeneration Research, 21(5), 1995-1996.

Lawal, O. P., Adekunle, J. F., Abiodun, A. V., Orobator, E. T., Agbo, O. S., Ugoagwu, K. U., ... & Elechi, K. W. (2025). Modulating gut microbiota for precision medicine in diabetes: a paradigm shift in personalized treatment strategies. Asian J Res Rep Endocrinol, 8(1), 94-109.

Lei, W., Cheng, Y., Liu, X., Gao, J., Zhu, Z., Ding, W., ... & Chen, X. (2025). Gut microbiota-driven neuroinflammation in Alzheimer’s disease: from mechanisms to therapeutic opportunities. Frontiers in Immunology, 16, 1582119.

Liu, Q., Dai, S., Li, X., Chen, Y., Wang, N., Wu, J., ... & Liu, Y. (2025). A review of brain research on T2DM-related cognitive dysfunction. Open Medicine, 20(1), 20251253.

Liu, W., Zhang, Q., & Liu, W. (2025). Facilitators and barriers of health behaviors in patients with type 2 diabetes: A qualitative study. The Science of Diabetes Self-Management and Care, 51(1), 47-63.

Lucia, S., Fornaro, S., Federici, M., & Rumiati, R. I. (2025). The impact of type 2 diabetes on aging: multidimensional approaches to preserve cognitive health. Acta Diabetologica, 62(12), 2223-2234.

Mahetlane, T. G. (2025). Experiences of people living with diabetes in Quthing (Master's thesis, National University of Lesotho).

Malih, N. (2026). Development and Evaluation of a Multifaceted Digital Health Intervention for Preventing Type 2 Diabetes Mellitus in Primary Care Settings: PREDIABETEXT Study.

Mehta, A., & Jayanna, K. (2025). The impact of chronic diseases on cognitive impairment in rural population of India: a focus on diabetes, hypertension, cardiovascular disease, and stroke. Brain Behavior and Immunity Integrative, 9, 100107.

Merie, H., Mussa, B. M., & Abusnana, S. (2026). The Role of Circadian Rhythm Dysregulation, Abnormal Sleep Patterns, and Sleep Disorders on the Development of Diabetes. Clocks & Sleep, 8(2), 22.

Nikolaidis, C. G., Gyriki, D., Stavropoulou, E., Karlafti, E., Didangelos, T., Tsigalou, C., & Thanopoulou, A. (2026). Gut Microbiota and Diabetic Complications: Potential Mechanisms, Microbial Signatures, and Clinical Implications. Microorganisms, 14(6), 1285.

Qi, L., Kang, H., Li, X., Wang, L., Lin, Y., Zhan, M., ... & Liu, L. (2026). Multi-omics profiling implicates gut microbiota-sphingolipid interplay in the neuroprotective effects of semaglutide on diabetic cognitive impairment. Frontiers in Microbiology, 17, 1705784.

Salam, M. A. (2025). Microbiota–Gut–Brain Axis: A New Horizon in Mapping Disease, Health and Beyond. TAJ: Journal of Teachers Association, 38(3), 167-181.

Sarkar, S., Roy, S., & Choudhury, L. (2026). Importance of the inflammasome in gut-brain axis: from pathological driver to therapeutic target. Inflammopharmacology, 1-27.

Shafik, A. N., Fahim, V. F., Iskander, F. A., Elsayegh, H. A., Serag, H., & Sallam, H. S. (2025, November). The Role of the Gut Microbiome Dysbiosis in Metabolic Dysfunction: A Mini Review. In Healthcare (Vol. 13, No. 23, p. 3029). MDPI.

Shanley, L., Powell, D., & Allan, J. (2026). The relationship between perceived executive function and self-reported self-management behaviour in adults with type 1 diabetes. Journal of Health Psychology, 31(1), 429-445.

Shareinia, H., Ghiyasvandian, S., Rooddehghan, Z., & Esteghamati, A. (2024). The formation of health-related procrastination in patients with type-2 diabetes: a grounded theory research. Frontiers in psychology, 14, 1196717.

Sharma, A. K., Akhtar, M. S., Orayj, K., Farooqui, S., Khan, A., & Sharma, G. (2026). Microbial dysbiosis in metabolic disorders: linking epigenomic regulation and pathological mechanisms. Drug Discovery Today, 104698.

Si, J., Yu, K., Hao, J., Wang, J., & Zhang, L. (2025). The therapeutic effects and mechanisms of glucagon-like peptide-1 receptor agonists in neurocognitive disorders. Therapeutic Advances in Neurological Disorders, 18, 17562864251332035.

Stajkovic, A. D., & Stajkovic, K. S. (2025). Human sustainability and cognitive overload at work: The psychological cost of working (p. 183). Taylor & Francis.

Tongta, S., Sungkaworn, T., & Pathomthongtaweechai, N. (2025). Neurobiological Mechanisms and Therapeutic Potential of Glucagon-like Peptide-1 Receptor Agonists in Binge Eating Disorder: A Narrative Review. International Journal of Molecular Sciences, 26(22), 10974.

Trajković, M., Popović-Ćitić, B., Bukvić, L., Bogićević, D., & Kovačević Lepojević, M. (2026). Predicting life satisfaction in adolescents: The role of socio-emotional competencies. In XXXII International scientific conference: Empirical studies in psychology (pp. 59-59). University of Belgrade-Faculty of Philosophy.

Uzay, B., Zhang, K. J., Monteggia, L. M., & Kavalali, E. T. (2026). Dopaminergic tone inhibits spontaneous glutamate release and augments homeostatic synaptic plasticity. Molecular psychiatry, 31(4), 2283-2297.

Wallace, C. W., & Fordahl, S. C. (2022). Obesity and dietary fat influence dopamine neurotransmission: exploring the convergence of metabolic state, physiological stress, and inflammation on dopaminergic control of food intake. Nutrition research reviews, 35(2), 236-251.

Yu, X., He, H., Wen, J., Xu, X., Ruan, Z., Hu, R., ... & Ju, H. (2025). Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments. Open Medicine, 20(1), 20241091.

Zeng, J., Hu, K., Wang, Z., Huang, Y. C., Zhang, Y., Peng, H., & Ma, S. (2025). Cognitive dysfunction and dementia in type 2 diabetes mellitus: insights into mechanisms, models, and therapeutics. ACS Pharmacology & Translational Science, 8(8), 2337-2352.

Zhang, Q., Jin, K., Chen, B., Liu, R., Cheng, S., Zhang, Y., & Lu, J. (2022). Overnutrition induced cognitive impairment: insulin resistance, gut-brain axis, and neuroinflammation. Frontiers in Neuroscience, 16, 884579.

Zhang, Y., Yu, Y., Xiong, Z., Bin, W., Yao, Y., & Liu, H. (2026). Pterostilbene in Oxidative Stress–Related Diseases: Context-Dependent Regulation of Redox Homeostasis and Translational Challenges. Drug Design, Development and Therapy, 608538.

Zhang, Z. T., Deng, S. M., Chen, C., He, Q. H., Peng, X. W., Liang, Q. F., ... & Tang, D. (2023). Pterostilbene could alleviate diabetic cognitive impairment by suppressing TLR4/NF‐кB pathway through microbiota‐gut‐brain axis. Phytotherapy Research, 37(8), 3522-3542.

Zhao, H., Ao, L., Hao, L., Wei, Y., Yin, H. Z., Lee, X. Q., ... & Zhou, G. L. (2026). Integrative mechanisms and intervention targets of the microbiota–gut–brain axis in depressive disorders: advances across immune, endocrine, and central nervous system pathways. Frontiers in Psychiatry, 17, 1848918.

Zhou, H., Ran, Y., Jiang, Y., & Li, R. (2026). Research Progress on Pathology, Molecular Mechanisms, and Intervention Strategies of Cognitive Dysfunction Associated with Type 2 Diabetes. International Journal of General Medicine, 582385.

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