Based on the role of TMAO in impairing insulin signaling and the microbiota-modulating properties of acarbose and vildagliptin, we hypothesize that both acarbose and vildagliptin reduce plasma TMAO concentrations in newly diagnosed T2DM patients, and that TMAO reduction correlates with improvements in insulin resistance (HOMA-IR). This evidence concerns the gene INS and type 2 diabetes mellitus.