TNF and type 2 diabetes mellitus: On the other hand, previous articles have reported that there is a strong association between gut microbiota dysbiosis, which is characterized by an increase in the number of proinflammatory Proteobacteria, and the bacterial endotoxin production, which promotes the expression of Toll-like receptor 4 (TLR4) and inflammatory markers (e.g., TNF-α) and increase IR level, eventually leading to hyperglycemia and T2D [45].