Managemrnt of Ciabetes Medicine volume 21 Probiotcis, Article number: Cite this article. Metrics mnaagement. This systematic diabetea and meta-analysis fiabetes aimed to evaluate the effectiveness of wakefulness and daytime fatigue supplementation on glycaemic control in patients with type 2 Probiorics mellitus T2DM based on the data from the BCAA and muscle glycogen synthesis clinical trials RCTs.
PubMed, Web of Sciences, Dibaetes, and Cochrane Library were searched Energy metabolism and vitamins the inception to Octoberand RCTs about probiotics and T2DM were collected. fasting blood glucose FBGinsulin, Prrobiotics A1c HbA1cand homeostasis Porbiotics of assessment of insulin resistance HOMA-IR.
Thirty RCTs including 1, T2MD patients maanagement identified. This fkr supported that diabettes supplementation had favourable effects on glycaemic control in Probiiotics patients. It may be managemsnt promising adjuvant therapy for patients with T2DM. Type 2 diabetes mellitus T2DMan endocrine and metabolic disease, is influenced by host physiology managemenf environmental diabeets [ 1 ].
More than million people are living with diabetes globally, and this number is expected to increase to million by managemnet 2 Probioyics. There Bone health facts no radical cure Active Travel Destinations T2DM [ 56 ], and its treatment relies mqnagement the long-term use of anti-diabetic drugs [ Probiotkcsffor Probiotics for diabetes management.
Therefore, it is crucial to explore new managemrnt Probiotics for diabetes management diabets effectively delay or even reverse the progression of T2DM.
Recent studies have shown that maangement gut microbiota plays a key role in the maintenance of host homeostasis and pathogenesis of T2DM [ 9 Probiltics, 10 ]. Probiotics are Probiotics for diabetes management dietary supplements that alter the gut microbiota. Some mwnagement controlled trials RCTs mannagement investigated the Heart health awareness campaigns of probiotic interventions on glycaemic Antioxidant-rich supplements in T2DM patients.
However, evidence from clinical trials on the effects of Liver detoxification drinks supplementation on glycaemic control remains inconsistent.
Asemi et al. Ffor, Razmpoosh et al. InLi et al. performed a systematic review and meta-analysis of dlabetes RCTs with Prrobiotics and reported that probiotic supplementation could alleviate FBG, but no significant differences were observed in the haemoglobin A1c Aging gracefully inspiration level or homeostatic doabetes assessment tor insulin managemetn HOMA-IR score between managmeent probiotic and control groups Sports nutrition tips T2DM patients [ 13 ].
InTao et al. Multipurpose slimming pills summarised 15 RCTs with individuals, and the results of the meta-analysis indicated that probiotic supplementation reduced HbA1c, FBG Probiotics for diabetes management insulin Blood sugar tips Probiotics for diabetes management in T2DM Prrobiotics [ 14 ].
Controversy still exists regarding the effects of probiotics on glycaemic control in T2DM patients. Variations in participant e. race and intervention characteristics e.
dose, probiotic genus, and Probiotids in Probiotic studies may have given rise manageent the contradictory results. No managfment has detected Mindful eating for appetite regulation in the effects of probiotic supplementation on glycaemic control according to the participant mabagement intervention characteristics.
In this systematic review managemnt meta-analysis, we aimed to evaluate the effects of a probiotic intervention on glycaemic control Probiogics T2DM patients and to evaluate the variations in these effects due to participant characteristics, e.
Fasting and gut health and baseline body mass diabetea BMIand intervention characteristics, Probiotics for diabetes management.
the Pobiotics dose, Problotics duration of the intervention, the probiotic genus, and Probjotics type of vehicle used riabetes deliver the probiotics.
This study followed the Preferred Reporting Items siabetes Systematic Reviews and Meta-Analyses statement [ 17 ] Additional file 1 : Table S1. The protocol for this study has been Probiorics at Prbiotics International Prospective Register fot Systematic Reviews registration number: CRD No language or Probiotics for diabetes management restrictions were applied during the Probiptics, and all relevant studies were found to be published in English.
A ffor search was also performed to Probiotlcs relevant studies from the references of the included Green apple sports beverage. FBG, insulin, and HbA1c levels and the HOMA-IR RMR and gender. Studies were excluded Proniotics the analysis if: 1 the Probiotics for diabetes management Progiotics other types of diabetes, Energy balance and micronutrient intake. gestational diabetes or type 1 diabetes or 2 the participants Vegan-friendly chocolate treats concurrently receiving other interventions, e.
synbiotics, herbs, prebiotics, or micro- nutrients. Two researchers Guang Li and Yan-Jun Deng independently performed the literature search and data extraction, and disagreements were resolved by a third senior researcher Su-Mei Xiao.
Basic information e. first author, year, and country of the study and the age, sex, and BMI of the participantsthe study design, intervention information probiotic genus and dose and duration of the interventionand outcomes were extracted from the included studies.
Two reviewers Xiao-Bao Wang and Qiong Zhang evaluated the quality of the included studies using the Cochrane risk-of-bias assessment tool. The risk of bias in the included studies was classified as low, unclear, or high.
The change in glycaemic control parameters was the primary outcome in this study. It was calculated as the final measurement value minus the baseline measurement value in each group. The mean and standard deviation SD of the change in glycaemic control parameters for the control group and the intervention group were extracted, respectively.
If the study provided the standard error SE of mean change, the SE was converted to SD based on the sample size.
For studies that did not directly report SD of mean change, the SDs of the baseline and final measurement values and the correlation coefficient Corr were used to calculated SD Effect,change SD E,change according to the following formula [ 18 ]:. Corr is the correlation coefficient between the baseline and final measurement values.
For the pretest—posttest design, presumably the correlation is at least 0. This was the Corr estimate value being used to impute the missing SDs of mean change in this study [ 1819 ]. If the study presented data in medians and quartiles, the mean and SD values were estimated [ 2021 ].
If the intervention included multiple time points, the longest intervention time was included in the analysis. The boundary values of the SMD were set at 0.
The inverse variance I 2 was used to assess the size of the heterogeneity. Subgroup analysis was used to explore the possible sources of heterogeneity. Subgroup analyses were performed for race Asian vs.
The leave-one-out approach was used in the sensitivity analysis. The database search yielded 4, records, and one additional record a conference paper [ 23 ] was obtained from the manual search of the references of the included RCTs.
A total of 1, records were then excluded due to duplication, leaving 2, articles for screening. After the screening based on the titles and abstracts, 2, articles were further excluded e.
reviews, protocols, animal studies, etc. The full texts of the remaining potentially relevant studies were assessed according to the inclusion and exclusion criteria.
Finally, thirty RCTs were included in this systematic review and meta-analysis Fig. PRISMA flowchart for search strategy and study selection process. RCT, randomised controlled trial; T2DM, type 2 diabetes mellitus; PRISMA, preferred reporting items for systematic reviews and meta-analyses; FBG, fasting blood glucose; HbA1c, haemoglobin A1c; HOMA-IR, homeostasis model of assessment of insulin resistance.
For the included 30 RCTs, all of them reported FBG, 17 RCTs reported HOMA-IR, 17 RCTs reported insulin, and 23 RCTs reported HbA1C Fig. Table 1 shows the basic information for the included 30 studies. Nine studies were conducted in Asian patients three in China [ 151624 ] and one each in India [ 25 ], Indonesia [ 26 ], Thailand [ 27 ], Japan [ 28 ], Malaysia [ 29 ], and Korea [ 30 ]19 studies were conducted in Caucasian patients 12 in Iran [ 111231323334353637383940 ] and one each in Ukraine [ 41 ], Turkey [ 23 ], Sweden [ 42 ], Saudi Arabia40 [ 43 ], Egypt [ 44 ], Denmark [ 45 ], and Australia [ 46 ] and two studies were conducted in other races two in Brazil [ 4748 ].
In the 30 RCTs, there were a total of 1, subjects, with in the probiotic group and in the control group. The Cochrane risk-of-bias assessment tool was used to assess the bias of the 30 included studies.
Overall, four of the studies were classified as high quality all terms were assessed as low risk19 studies were classified as moderate quality no term was assessed as a high risk and one or more terms were assessed as unclear risksand seven studies were classified as low quality one or more terms were assessed as a high risk.
The general and individual risks of bias are shown in Additional file 3 : Fig. Thirty studies including a total of 1, T2DM patients were used to evaluate the effects of probiotic supplementation on FBG level.
Leave-one-out sensitivity analysis confirmed that the pooled effects of probiotic supplementation on FBG level were stable and reliable Additional file 4 : Fig. Forest plots of the effects of probiotics on a FBG, b Insulin, c HBA1c and d HOMR-IR.
FBG, Fating blood glucose; HbA1c, Haemoglobin A1c; HOMA-IR, Homeostsis model of assessment of insulin resistance. Subgroup analyses for FBG were performed according to race, probiotic intervention dose, probiotics genus, type of vehicle used to deliver the probiotics, and baseline BMI.
Caucasiangenus of probiotics Lactobacillus vs. Bifidobacterium vs. Eight hundred and eighty-six patients in 17 RCTs were included in the meta-analysis of the effects of probiotic intake on insulin level.
Sensitivity analysis also supported the robustness of the results for insulin level Additional file 4 : Fig. The effects of probiotic interventions on HbA1c level were evaluated in 23 RCTs including 1, T2DM patients.
A significant decrease was observed in the HbA1c level in the probiotic group Fig. Sensitivity analysis showed that the results for HbA1 level were stable and reliable Additional file 4 : Fig.
The subgroup analysis was performed for HbA1c according to races Asian vs. Caucasiangenera of probiotics Lactobacillus vs. Lactobacillus and Bifidobacteriumtypes of vehicle used to deliver the probiotics food vs.
Sensitivity analysis showed that the pooled effects of probiotic supplementation on HOMA-IR scores did not significantly change, suggesting that the meta-analysis results were stable and reliable Additional file 4 : Fig.
A visual inspection of the funnel plots revealed no publication bias for FBG, insulin, or HbA1c levels or the HOMA-IR score Additional file 5 : Fig. This systematic review and meta-analysis summarised data from 30 RCTs, including a total of 1, individuals, to evaluate the effects of probiotic supplementation on glycaemic control in T2DM patients.
The results revealed that probiotic supplementation significantly decreased FBG, insulin, and HbA1c levels and HOMA-IR scores in T2DM patients.
This study supported the notion that probiotics improve glycaemic control in T2DM patients. This is inconsistent with the results reported by the systematic review and meta-analysis of 12 RCTs in [ 13 ]. They found no significant differences in the HbA1c level and HOMA-IR score between the probiotic and control groups of T2DM patients.
These may partially explained the differences between the two studies. The gut microbiota is largely involved in the metabolic, nutritional, physiological, and immune functions of the host [ 495051 ].
A previous study showed that T2DM patients are characterised by a decrease in the abundance of certain butyrate-producing bacteria and the enrichment of other microbial functions conferring sulphate reduction and oxidative stress resistance [ 52 ].
Changes in the gut microbial composition may be a mechanism whereby probiotic supplementation improves glycaemic control.
: Probiotics for diabetes management| Probiotics for diabetes: Does this treatment work? | Another study 4 conducted in , found that probiotic supplementation with Lactobacillus casei may be useful in preventing insulin resistance caused by excessive consumption of high-fat foods. The main finding of the study was that supplementation with the LcS probiotic preserved glycaemic control and maintained the action of insulin. These studies suggest that intervention with beneficial bacteria can help balance insulin levels in both animals and humans. However, more research is needed as researchers couldn't be sure as to the exact mechanism of how this was taking place. Did you know our bodies are home to more bacterial cells than human cells? Scientists have begun to analyse the significance of the symbiotic relationship, and more specifically; the impact that the bacteria have on our metagenome — the entire collection of genes from ourselves and the microorganisms we share our body with. It is well documented that those with type 2 diabetes have an entirely different composition of gut microbiota than healthy people 5. This over the years has led researchers to develop a new model for early diagnosis, with better predictive value than the model used currently, which uses body-mass index and waist-hip ratio. The question is — does the composition of the gut microbiota promote the onset of age-related diabetes? If this is the case, this would indicate new opportunities to prevent disease. Further studies have been conducted to support this theory, suggesting that the composition of intestinal bacteria changes over time in a negative way in those people who are pre-diabetic and this could therefore possibly be a predictor of diabetes 6. In this particular study, researchers found that the men whose blood sugar control was stable during the study had more gut bacteria that are considered beneficial for metabolic health. Furthermore, the men who had improved glucose control over the course of the study were found to have higher levels of Akkermansia , which is again associated with better metabolic health. What these studies show us is that although there has been previous research linking the balance of our gut bacteria with type 2 diabetes, this is the first piece of research to suggest that the alteration in the composition of our gut bacteria can be seen in the early stages of diabetes, or pre-diabetes. Going forward future studies need to be conducted to determine if it is the changes in gut bacteria that can affect the development of type 2 diabetes. Otherwise, we will not know If the changes simply reflect that the person is suffering from type 2 diabetes. Boutant M, Ramos OH, Tourrel-Cuzin C, Movassat J, Ilias A, Vallois D, et al. COUP-TFII controls mouse pancreatic β-cell mass through GLPβ-catenin signaling pathways. Burcelin R, Serino M, Chabo C, Blasco-Baque V, Amar J. Gut microbiota and diabetes: from pathogenesis to therapeutic perspective. Okeke F, Roland BC, Mullin GE. The role of the gut microbiome in the pathogenesis and treatment of obesity. Glob Adv Health Med. Shapiro H, Kolodziejczyk AA, Halstuch D, Elinav E. Bile acids in glucose metabolism in health and disease. J Exp Med. Winer S, Chan Y, Paltser G, Truong D, Tsui H, Bahrami J, et al. Normalization of obesity-associated insulin resistance through immunotherapy. Nat Med. Richardson SJ, Willcox A, Bone AJ, Foulis AK, Morgan NG. Islet-associated macrophages in type 2 diabetes. Yu R, Kim CS, Kang JH. Inflammatory components of adipose tissue as target for treatment of metabolic syndrome. Forum Nutr. Torres S, Fabersani E, Marquez A, Gauffin-Cano P. Adipose tissue inflammation and metabolic syndrome. The proactive role of probiotics. Eur J Nutr. Li J, Hou Q, Zhang J, Xu H, Sun Z, Menghe B, et al. Carbohydrate staple food modulates gut microbiota of mongolians in China. Front Microbiol. Chen J, Wright K, Davis JM, Jeraldo P, Marietta EV, Murray J, et al. An expansion of rare lineage intestinal microbes characterizes rheumatoid arthritis. Genome Med. Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Allin KH, Nielsen T, Pedersen O. Mechanisms in endocrinology: gut microbiota in patients with type 2 diabetes mellitus. Eur J Endocrinol. Aitken JD, Gewirtz AT. Gut microbiota in toward understanding and manipulating the gut microbiota. Nat Rev Gastroenterol Hepatol. Taghizadeh M, Asemi Z. Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial. Horm Athens. Lye HS, Rusul G, Liong MT. Removal of cholesterol by lactobacilli via incorporation and conversion to coprostanol. J Dairy Sci. Ooi LG, Liong MT. Cholesterol-lowering effects of probiotics and prebiotics: a review of in vivo and in vitro findings. Int J Mol Sci. Paone P, Cani PD. Mucus barrier, mucins and gut microbiota: the expected slimy partners? Bron PA, Kleerebezem M, Brummer RJ, Cani PD, Mercenier A, MacDonald TT, et al. Can probiotics modulate human disease by impacting intestinal barrier function? Br J Nutr. Sicard JF, Le Bihan G, Vogeleer P, Jacques M, Harel J. Interactions of intestinal bacteria with components of the intestinal mucus. Front Cell Infect Microbiol. Ahl D, Liu H, Schreiber O, Roos S, Phillipson M, Holm L. Lactobacillus reuteri increases mucus thickness and ameliorates dextran sulphate sodium-induced colitis in mice. Acta Physiol Oxf. Shin NR, Lee JC, Lee HY, Kim MS, Whon TW, Lee MS, et al. An increase in the Akkermansia spp. population induced by metformin treatment improves glucose homeostasis in diet-induced obese mice. Cabello-Olmo M, Oneca M, Pajares MJ, Jiménez M, Ayo J, Encío IJ, et al. Antidiabetic effects of Pediococcus acidilactici pA1c on HFD-induced mice. Gutteridge JM, Richmond R, Halliwell B. Inhibition of the iron-catalysed formation of hydroxyl radicals from superoxide and of lipid peroxidation by desferrioxamine. Biochem J. Landis GN, Tower J. Superoxide dismutase evolution and life span regulation. Mech Ageing Dev. Pompei A, Cordisco L, Amaretti A, Zanoni S, Matteuzzi D, Rossi M. Folate production by bifidobacteria as a potential probiotic property. Hensley K, Robinson KA, Gabbita SP, Salsman S, Floyd RA. Reactive oxygen species, cell signaling, and cell injury. Free Radic Biol Med. Kobayashi M, Li L, Iwamoto N, Nakajima-Takagi Y, Kaneko H, Nakayama Y, et al. The antioxidant defense system Keap1-Nrf2 comprises a multiple sensing mechanism for responding to a wide range of chemical compounds. Mol Cell Biol. Seth A, Yan F, Polk DB, Rao RK. Probiotics ameliorate the hydrogen peroxide-induced epithelial barrier disruption by a PKC- and MAP kinase-dependent mechanism. Am J Physiol Gastrointest Liver Physiol. Blumberg PM. Complexities of the protein kinase C pathway. Mol Carcinog. Anini Y, Brubaker PL. Role of leptin in the regulation of glucagon-like peptide-1 secretion. Darby TM, Naudin CR, Luo L, Jones RM. Lactobacillus rhamnosus GG-induced expression of leptin in the intestine orchestrates epithelial cell proliferation. Cell Mol Gastroenterol Hepatol. Rodrigues RR, Gurung M, Li Z, García-Jaramillo M, Greer R, Gaulke C, Bauchinger F, You H, Pederson JW, Vasquez-Perez S, White KD, Frink B, Philmus B, Jump DB, Trinchieri G, Berry D, Sharpton TJ, Dzutsev A, Morgun A, Shulzhenko N. Transkingdom interactions between Lactobacilli and hepatic mitochondria attenuate western diet-induced diabetes. Nat Commun. Orellana-Gavalda JM, et al. Molecular therapy for obesity and diabetes based on a long-term increase in hepatic fatty-acid oxidation. Perry RJ, Samuel VT, Petersen KF, Shulman GI. The role of hepatic lipids in hepatic insulin resistance and type 2 diabetes. Kansra AR, Lakkunarajah S, Jay MS. Childhood and Adolescent Obesity: A Review. 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Pediatric Type 2 Diabetes: Not a Mini Version of Adult Type 2 Diabetes. Endocrinol Metab Clin North Am. Sharma P, Tomar SK, Goswami P, Sangwan V, Singh R. Antibiotic resistance among commerciallyavailable probiotics. Food Res Int. Zhang ZY, Liu C, Guo XK. Safety of probiotics[J]. Journal of Microbiology, 02 — Sharifi-Rad J, Rodrigues CF, Stojanović-Radić Z, Dimitrijević M, Aleksić A, Neffe-Skocińska K, Zielińska D, Kołożyn-Krajewska D, Salehi B, Milton Prabu S, Schutz F, Docea AO, Martins N, Calina D. Probiotics: Versatile Bioactive Components in Promoting Human Health. Medicina Kaunas. Whelan K, Myers CE. Safety of probiotics in patients receiving nutritional support: A systematic review ofcase reports, randomized controlled trials, and nonrandomized trials. J Clin Nutr. Guo TC. Prospects of probiotics in biomedical applications[J]. Food Safety Guide,, 03 Sanders ME, Akkermans LM, Haller D, Hammerman C, Heimbach JT, Hörmannsperger G, Huys G. Safety assessment of probiotics for human use. Gut Microbes. Download references. This study was funded by the Key Laboratory of TCM Health Cultivation of Beijing, Beijing International Science and Technology Cooperation Base. Grant Number: No BZ Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, , Beijing, China. You can also search for this author in PubMed Google Scholar. YL conceived the theme of the study. YL, LW and LQ conducted the literature search and data extraction and evaluated the risk of bias included in the literature. YW and YL analysed the data. YL wrote the original manuscript. YW and TH checked and modified the manuscript. All authors have read and approved the current manuscript. Correspondence to Tonghua Liu. All authors agreed to publish the manuscript. What we have done is not involved in previous studies. This manuscript will not be published elsewhere. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Li, Y. et al. The effects of probiotic administration on patients with prediabetes: a meta-analysis and systematic review. J Transl Med 20 , Download citation. Received : 11 August Revised : 26 September Accepted : 06 October Published : 02 November Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background This paper aimed to examine the effects of probiotics on eight factors in the prediabetic population by meta-analysis, namely, fasting blood glucose FBG , glycated haemoglobin A1c HbA1c , homeostatic model assessment of insulin resistance HOMA-IR , quantitative insulin sensitivity check index QUICKI , total cholesterol TC , triglyceride TG , high-density lipoprotein cholesterol HDL-C and low-density lipoprotein cholesterol LDL-C , and the mechanisms of action are summarized from the existing studies. Methods Seven databases PubMed, Web of Science, Embase, Cochrane Library, SinoMed, CNKI, and Wanfang Med were searched until March Results Seven publications with a total of patients were included. Conclusion The present study clearly indicated that probiotics may fulfil an important role in the regulation of HbA1c, QUICKI, TC, TG and LDL-C in patients with prediabetes. Trial Registration This meta-analysis has been registered at PROSPERO with ID: CRD Background Diabetes and its complications are among the chronic noncommunicable diseases that pose a serious threat to public health [ 1 ]. Materials and methods Search strategy This meta-analysis and systematic review were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement [ 19 ]. Study selection Inclusion criteria Only randomized controlled trials of probiotics for prediabetes were selected. Patients with diabetes, in particular, may be curious about whether they can take probiotics and how probiotics may affect their blood sugar levels. As it turns out, research has shown several potential benefits of probiotics for diabetes. This post will address questions such as: Can a diabetic take probiotics, do probiotics help diabetes, and what types of probiotics are best for diabetes management? Probiotics are live microorganisms that are believed to provide health benefits when consumed in adequate amounts. They are typically found in fermented foods such as yogurt, kefir, kimchi, and sauerkraut—as well as in dietary supplements. Various strains of bacteria in probiotics may help support a healthy balance of microorganisms in the gut. Different strains may be recommended depending on the intended use. They may work through different mechanisms for Type 2 diabetes, such as improved glucose metabolism and decreased insulin resistance. They may also help support the gut lining, reduce inflammatory markers, and regulate the digestion of carbohydrates. Several clinical studies have investigated the potential benefits of probiotics for diabetes management. These studies have assessed the effects of various species and strains of probiotics. The main genera of bacteria studied were Lactobacillus and Bifidobacterium. One study published in Advances in Nutrition found that probiotics can contribute to glycemic control in patients with Type 2 diabetes. The study showed that probiotics could improve glycemic control by reducing fasting blood glucose levels and HbA1c levels. However, the effect of probiotics on glucose levels was more pronounced in patients with poorly controlled diabetes or those not on insulin therapy. Another meta-analysis published in Translational Medicine found that probiotic treatment may reduce HbA1c, fasting blood glucose levels, and insulin resistance levels in Type 2 diabetes patients. The study assessed 15 randomized controlled trials with almost 1, participants and found that probiotics significantly improve metrics used to monitor Type 2 diabetes. The researchers concluded that probiotics could be a safe and effective adjunct therapy for managing Type 2 diabetes. A recent study published in Diabetes evaluated the use of a specific bacteria known for generating a fatty acid called butyrate. The study found that the genus Coprococcus was associated with increased insulin sensitivity and decreased dysglycemia. Supplementation with this bacteria may be considered a potential treatment pathway for Type 2 diabetes patients. |
| Role of Probiotics in Diabetes Control | SpringerLink | Effect of probiotics on lipid profile, glycemic control, insulin action, oxidative stress, and inflammatory markers in patients with type 2 diabetes: a clinical trial. Khalili L, Alipour B, Jafarabadi MA, Hassanalilou T, Abbasi MM, Faraji I b Probiotic assisted weight management as a main factor for glycemic control in patients with type 2 diabetes: a randomized controlled trial. Methods: RCTs of pro-, pre-, synbiotics for the treatment of pre-diabetes population will be summarized. Impact of probiotic intake on the glycemic control, lipid profile and inflammatory markers among patients with type 2 diabetes mellitus. Lipopolysaccharides LPS , a main outer cell membrane component of Gram-negative bacteria, can exist in high concentrations and be absorbed by intestines Accordingly, we performed the present meta-analysis to determine whether probiotics are beneficial in prediabetes and to discuss their mechanisms of action on the basis of existing studies. |
| Top bar navigation | Enter password again. Already have an account? Sign In. Welcome back Sign in to your account with Continue with Google. Lost your password? Don't have an account? Sign Up. Reset Your Password Don't worry. We will email you instructions to reset your password. Return to sign in. Emily Schilling , 1 year ago 3 5 min read. What are Probiotics? Probiotic Food Sources Probiotics are found in many fermented foods. Foods that are particularly rich in prebiotics are things like: Garlic Bananas Whole grains e. Probiotics and Heart Health People with diabetes are at increased risk for heart disease. According to the National Institutes of Health , certain probiotics found in foods and supplements may help lower total and LDL cholesterol levels: Talk to your healthcare team about probiotics for heart health, as research is constantly evolving, and everyone has unique health needs. Probiotics and Periodontal Disease Periodontal gum disease is more prevalent among people with diabetes. Probiotics and Gastroparesis Gastroparesis is a complication of diabetes that seems to be more common in those with T1D. Summary While definitive research on probiotics and T1D is lacking, a healthy microbiome may improve your overall health. Emily Schilling Emily Schilling is a Registered Dietitian and Certified Diabetes Care and Education Specialist working in Boston, Massachusetts. Emily has been living well with T1D since and draws on personal and professional experience to educate and inspire others living with diabetes. com for more diabetes, nutrition, and lifestyle inspiration and information. Related Stories. Carb Counting and Beyond: Navigating Nutrition with Diabetes Tara Mayo , 3 weeks ago 7 min read. Navigating Greek Life in College with Type 1 Diabetes Shay Webb , 4 weeks ago 5 min read. How to Meet People with Type 1 Diabetes in Your Local Community Sarah Howard , 3 months ago 3 min read. Kids with Type 1 Diabetes Can Enjoy Halloween, Too Tara Mayo , 4 months ago 4 min read. Pingback: Probiotics and Diabetes - My Teens Heath. Pingback: Probiotics and Diabetes. Cheryl Seibert Excellent article! Probiotics and Diabetes Cancel reply You must be logged in to post a comment. FOLLOW US ON INSTAGRAM. t1dexchange This error message is only visible to WordPress admins There has been a problem with your Instagram Feed. Privacy Policy. Terms of Use. Follow Us facebook twitter linkedin instagram. All Rights Reserved. Login Register. Username or Email Address Password Forgot Password Remember Me. Username Email Registration confirmation will be emailed to you. Skip Next Finish. Account successfully created. Please check your inbox and verify your email in the next 24 hours. Your Account Type Please select all that apply. Patients should consult with their healthcare providers to determine the most appropriate probiotic strains, dosages, and formulations to support their health goals and ensure the probiotic does not interfere with any ongoing medications or treatments. The potency and effectiveness of probiotics can decrease over time, so it is important for patients to check the expiration date and choose a product that is well within its shelf life. Using expired probiotics may result in reduced effectiveness or even potential harm. Probiotics are not regulated by the FDA as drugs. For this reason, many patients may turn to pharmacists for more information about their potential uses. The research suggests that probiotics could be an effective and safe treatment option for managing diabetes, especially when used with conventional treatments like medication. However, patients should not be recommended probiotics as a cure for Type 2 diabetes. More research is needed to determine the optimal dosage, duration, and type of probiotic for diabetes management. Skip to main content Search for a topic or drug. Health Education Drug Info Wellness News Community More Drug vs. Drug The Checkout Pets Company Health conditions SingleCare discount cards Browse prescriptions Medicare. Can probiotics help treat diabetes? See what research says when counseling patients in these dietary supplements. By Gerardo Sison, Pharm. Share on Facebook Facebook Logo Share on Twitter Twitter Logo Share on LinkedIn LinkedIn Logo Copy URL to clipboard Share Icon URL copied to clipboard. Sharing options Share Icon. Top Reads in The Checkout. Helping patients with insomnia Dec. Looking for a prescription? Search now! Type your drug name. Pendulum Glucose Control is only medical probiotic available that has demonstrated clinical efficacy for the dietary management of Type 2 diabetes in people taking metformin. Fermented foods are foods containing microorganisms bacteria or yeast and that have been changed by the actions of those microorganisms. In other words, the bacteria or yeast in these foods have eaten some of the nutrients in the food and, in turn, have produced their own molecules. This process accounts for the powerful flavors in kombucha, kimchi, sauerkraut, and tempeh. Dietary fibers are excellent for this because the human body struggles to digest fibers. However, many species of bacteria in the gut are able to break down fiber and use it to churn out beneficial signaling molecules such as butyrate There are prebiotic elements to many different foods including:. However, the amount of prebiotic compounds in these foods can be quite small. This is why some probiotics contain the prebiotic inulin or other such prebiotic compounds. Including these in the probiotic can help ensure the bacteria grow once in the gut A clinical trial using 5 strains targeted to help with Type 2 diabetes showed a significant reduction in A1C levels in people with Type 2 diabetes. However, most commercially available probiotics have not been shown to affect blood sugar. Prebiotics can be helpful for people with diabetes because they encourage growth of potentially beneficial bacteria. Increasing fibers in your diet may help you cultivate a diverse microbiome and potentially improve symptoms of diabetes 1 , 2 , 3 , 12 , 13 , In most cases, yes. The probiotic should have demonstrated safety in humans and clear dosing instructions. It is important to discuss probiotics with your doctor and work with them to determine a safe approach. Before making a decision about which probiotics you take, and how often you take them, you should have a conversation with your healthcare provider to determine what is likely to be the safest and most effective for you. Pendulum Glucose Control is designed to be taken twice daily. Close Not ready to purchase? Stay in touch about special discounts, nutrition tips and additional education. The Digest. All Articles. What are the Best Probiotics for Managing Type 2 Diabetes? Some bacteria specialize in thriving in the harsh mucus layer that coats the inner lining of the intestines Others specialize in the types of food they consume One important difference that can exist between species is the mixture of waste products—essentially bacteria poop—and signaling molecules that they release into their environment. What are probiotics? |
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Institute for Translational Medicine, Medical School, University of Pécs, 12 Szigeti str. Hungarian Academy of Sciences, University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary. Szentágothai Research Center, University of Pécs, Pecs, Hungary. Heart Institute, Medical School, University of Pécs, Pecs, Hungary. You can also search for this author in PubMed Google Scholar. All authors have made substantial contributions to this study. and Z. All authors have approved the submitted version and agree to assume responsibility for this work. Correspondence to Margit Solymár. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Kocsis, T. Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials. Sci Rep 10 , Download citation. Received : 26 April Accepted : 23 June Published : 16 July Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Probiotics and Antimicrobial Proteins By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily. Skip to main content Thank you for visiting nature. nature scientific reports articles article. Download PDF. Subjects Diabetes Dyslipidaemias. Abstract Probiotics have been reported to have a positive impact on the metabolic control of patients with type 2 diabetes. Alongside physical activity and healthy eating, cultivating a diverse gut microbiome is an important part of controlling Type 2 diabetes. The gut microbiome is a microscopic ecosystem teaming with unseen life. Like most ecosystems, the gut microbiome appears to be at its healthiest when it contains a diversity of species in this case, bacterial species. Over the past few decades, researchers have found that people with Type 2 diabetes often have a less diverse gut microbiome compared to people without Type 2 diabetes. This suggests that one way to manage Type 2 diabetes or possibly to prevent it is through the use of probiotics. These microorganisms can be found in both foods e. yogurt, kefir, sauerkraut and supplements e. Pendulum Glucose Control; Pendulum Akkermansia , and Butyricum that help increase the presence of certain bacteria in the gut microbiome. This can result in chronically elevated blood-sugar levels. The human gut microbiome is home to a thriving ecosystem of trillions of microorganisms—each of which are always competing or cooperating with one another to secure food, space, and survival. Like all other ecosystems, the gut microbiome appears to be at its healthiest when it consists of a diverse number of species 1 , 2 , 3. Each species of bacteria is unique, having adapted to life in the intestine in their own way. One important difference that can exist between species is the mixture of waste products—essentially bacteria poop—and signaling molecules that they release into their environment. For example, one species of bacteria in the gut microbiome known as Clostridium butyricum feeds on dietary fiber —a certain type of carbohydrate that human cells cannot easily digest. As these bacteria dine on fiber, they produce a molecule known as butyrate which nearby human cells can use for energy. Research suggests there are multiple ways in which a healthy gut microbiome may protect us from Type 2 diabetes. However, if this continues over a long period of time, it may contribute to chronically elevated blood glucose levels and Type 2 diabetes 8. Research also shows that people with Type 2 diabetes may have lost some bacteria in their gut microbiome—such as Akkermansia muciniphila. Exactly why there is a decrease in beneficial bacteria as Type 2 diabetes develops is unclear. However, a large amount of evidence suggests that a loss of diversity in the gut microbiome leads to a loss of potentially beneficial bacteria and a growth in potentially harmful bacteria. A probiotic is a live microorganism typically bacteria naturally found in the human body that may provide some sort of health benefit Probiotics can come in many forms, such as foods or as supplements that were deliberately designed to help manage specific health conditions such as Type 2 diabetes. Prebiotics are compounds—such as dietary fibers—that serve as food for specific species of good bacteria or, in some cases, fungi Because they cannot be digested or absorbed by human cells, prebiotics can be digested by specific forms of beneficial microorganisms. Many researchers have studied if and how probiotics may help people with Type 2 diabetes, and have found mixed results 13 , 14 , 15 , 16 , The gut microbiome is home to many different bacterial species and there are likely more that we have not yet discovered. Meanwhile, the prevalence of pre-diabetes can be inferred by IGT because it is a unified item in all diagnostic standards. In , the International Diabetes Federation IDF reported that 7. The number of those people is expected to Although the conversion rate is different between nations, ~9. For this reason, it is imperative to prevent or retard the reversible process to T2D among people with pre-diabetes to reduce the burden of T2D. Previous studies suggest that gut microbiota plays an important role in the development of insulin resistance and diabetes mellitus 9. Gut microbiota can affect metabolic disorders through different potential mechanisms, including modulation of inflammation, gut permeability, glucose metabolism, energy expenditure and fatty acid oxidation and synthesis Therefore, diet-related interventions can be recommended as a useful strategy to control pre-diabetes and prevent or delay T2D by causing beneficial changes in gut microbiota. It has been suggested that oral administration of probiotics, pre-biotics and synbiotics can be an effective method to change gut microbiota composition in pre-diabetes population Gut microbiota is not only digestive but also related to the pathogenesis of many metabolic diseases, such as obesity 12 , diabetes 13 , non-alcoholic fatty liver Due to the use of genetic factors, lifestyles, antibiotics and changes in diet structure, the diversity of gut microbiota has changed and is characterized by inter-individual variability It plays an important role in T2D and pre-diabetes, including inflammatory response, dietary nutrition, gut permeability, glucose and lipid metabolism, insulin sensitivity and energy homeostasis The possible relationship between gut microbiota and pre-diabetes is shown in Figure 1. Figure 1. The possible relationship between gut microbiota and pre-diabetes. Created with BioRender. It is reported that the number of bacteria related to short-chain fatty acids SCFAs was lower in T2D patients Disturbance of gut microbiota may lead to decreased production of SCFAs, leading to increased inflammatory factors, affecting insulin secretion and sensitivity of islet β cells, and producing insulin resistance SCFAs, especially butyrate, promote the secretion of glucagon-like peptide GLP -1, which prevents the secretion of glucagon, inhibits gluconeogenesis in the liver, and improves insulin sensitivity In addition, SCFAs can impede the low-grade inflammation caused by bacteria migration from gut to mesenteric adipose tissue and blood These suggest that the increase of SCFAs, particularly butyrate, are important for preventing and controlling pre-diabetes. A high-fat diet can increase the percentage of Gram-negative species in gut microbiota Lipopolysaccharides LPS , a main outer cell membrane component of Gram-negative bacteria, can exist in high concentrations and be absorbed by intestines Furthermore, LPS stimulates the inactive immune system by binding with toll-like receptor TLR , activating immune cells to release inflammatory cytokines, which promotes insulin resistance caused by an endotoxin-induced inflammatory response Another potential mechanism associated with gut ecosystem homeostasis is the endocannabinoid system. LPS interacts with endocannabinoid receptors eCB1 , modulating gut permeability and LPS translocation, increasing levels of circulating level of LPS and inducing metabolic endotoxemia Cholic acid and chenodenxycholic acid are primary bile acids BA produced by cholesterol in the liver, and primary BA are converted into secondary BA in the intestine Gut microbiota participates in the biotransformation of BA through deconjugation, dehydroxylation, and re-conjugation of BA Moreover, BA is involved in regulating glucose homeostasis as a signaling molecule and cell receptor, directly activating the nuclear farnesoid X receptor FXR and the Takeda G protein-coupled receptor 5 TGR5 signals and indirectly promoting FXR-dependent induction of intestinal fibroblast growth factor FGF19 TGR5 activation can induce pre-proglucagon gene expression and GLP-1 secretion 17 , On the contrary, FXR activation suppresses the pre-proglucagon gene expression and GLP-1 secretion by inhibiting glycolysis and ChREBP activity in L-cells Therefore, in intestinal endocrine L-cells, BA act through the opposite effects on TGR5 and FXR to regulate the production and secretion of GLP-1, thereby maintaining weight loss and improving glucose tolerance. Gut bacteria metabolize dietary nutrients to produce trimethylamine TMA , which is then converted to trimethylamine N-oxide TMAO in the liver. The previous study has shown that TMAO levels are elevated in T2D patients Also, animal models have shown that dietary TMAO can exacerbate impaired glucose tolerance and increase fasting insulin levels by blocking the hepatic insulin signaling pathway and causing inflammation in adipose tissue Although a prospective study showed that a higher intake of phosphatidylcholine the pre-cursor for TMAO generation was independently associated with an increased risk of T2D 30 , the association between TMAO and T2D has not reached a consistent conclusion. Roy et al. The relationship between plasma TMAO and diabetes has not been elucidated, and more researches are needed to explore the development mechanism in the future. Overall, the gut microbiota influences host metabolic disorders via the modulation of metabolites, including SCFAs, the endotoxin LPS, BA, and TMAO, as well as mediating the interaction between the gastrointestinal system and other organs. In this review, randomized controlled studies RCTs of pro-, pre-, synbiotics for the treatment of pre-diabetes population will be summarized. The following electronic bibliographic databases will be searched from inception to February EMBASE, MEDLINE, Web of Science, Cochrane Central. Meanwhile, Clinical Trials ClinicalTrials. gov will also be searched. The stepwise procedure of the selected studies was shown in the flow diagram of Figure 2. Finally, a total of 8 RCTs are included in the current review, shown in Table 1. Table 1. Human clinical trials of probiotics, pre-biotics, and synbiotics for the treatment of pre-diabetes. The main advantage of probiotics is to ensure the proper balance between pathogens and bacteria that are necessary for the normal function of the organism by affecting the development of the host microbiome 41 , Previous molecular and genetic studies provide four mechanisms of the beneficial effect of probiotics: 1 Antagonism through the production of antimicrobial substances 43 ; 2 Competition with pathogens for adhesion to the epithelium and for nutrients 44 ; 3 Immunomodulation of the host 45 ; 4 Inhibition of bacterial toxin production Nowadays, several studies showed that probiotics could exert antidiabetic effects, improve glucose homeostasis and delay the progression of diabetes 47 — The glucose metabolic outcomes of probiotics treatment for pre-diabetes are inconsistent. Naito et al. The reduction in GA levels was statistically significantly greater in the probiotics group than in the placebo group. Interestingly, in this study, stratified analyses revealed significantly improved 1-h post-load PG and GA levels in the probiotics group compared with the placebo group among subjects with severe glucose intolerance 2-h post-load PG levels higher than the median at baseline. Another pilot study 37 conducted by Stefanaki et al. Kassaian et al. There is a significant reduction in HbA 1 c compared with the placebo group and a decrease in FPG compared with baseline. Meanwhile, homoeostasis model assessment for insulin resistance HOMA-IR and β-cell function HOMA-β were not found to be different between the probiotics group and the placebo group 35 , Recently, a study including 26 pre-diabetic patients demonstrated no statistically significant difference observed between the probiotic and placebo groups regarding HbA 1 c, FPG, fasting insulin or c-peptide Although previous studies have shown that probiotics can improve cholesterol levels in patients with type 2 diabetes 56 , they have not been confirmed in patients with pre-diabetes 33 , 35 , This increase may be related to the season change. The results showed that the serum total cholesterol TC , high-density lipoprotein-cholesterol HDL-C , and non-LDL-C levels in the placebo group increased significantly, while the probiotics group maintained a constant level, indicating that probiotics supplementation can suppress the rise of blood cholesterol, but there is no improvement. Mahboobi et al. However, Naito et al. Only two studies reported group differences in intestinal microbiome populations at baseline and post-intervention. In one study by Kassaian et al. In another study by Stefanaki et al. and Butyrivibrio crossotus, Collinsella aerofaciens, Faecalibacterium prausnitzii, Escherichia coli, Akkermancia muciniphila , compared to the control group. These populations are reported to associate with obesity 57 , insulin resistance 58 , gut permeability 59 , and anti-inflammation Pre-biotics are non-digestible food ingredients that can be obtained from fruit, vegetables, cereals, and other edible plants. Pre-biotics can produce SCFAs, l-lactate, Carbon dioxide CO 2 , hydrogen, methane, and other metabolites that regulate downstream metabolic process As a result, pre-biotics do not promote human nutrition, but they can produce beneficial metabolism and health benefits for the host [ A previous animal study has shown that a pre-biotic treatment decreased intestinal permeability and increased GLP-2 secretion, and reduced the hepatic expression of inflammatory and oxidative stress markers of obese and diabetic mice, as well as LPS level Pre-biotics can also improve glucose levels and insulin resistance A study evaluated the effect of the pre-biotics xylooligosaccharide XOS in pre-diabetic subjects In the gut microbiome, XOS can decrease or reverse the increase in abundance of Howardella, Enterorhabdus , and Slackia , which were observed to be higher in pre-diabetic patients. In contrast, XOS can increase the abundance of Blautia hydrogenotrophica , which was lower in those subjects. Although OGTT 2-h insulin response showed a tendency to decrease with XOS intervention, there were no significant differences observed in serum glucose, HOMA-IR, active GLP-1, TG, leptin, pancreatic polypeptides PP , or the inflammatory marker TNFα. Similar to XOS, galacto-oligosaccharides GOS is another supplementation of pre-biotic. Canfora et al. and decreased Bacteroides stercoris er rel. and Sutterella wadsworthia et rel. However, there was no significantly difference in glucose metabolism, SCFAs, gut-derived hormones, inflammation markers and insulin sensitivity. Pre-biotics supplementation has been suggested as a strategy to reduce TMA synthetic capacity by modulating gut microbiota composition However, Baugh et al. Synbiotics are a mixture of probiotics and pre-biotics. Considering the fact that probiotics are basically active in the small and large intestines, while the effects of probiotics are mainly observed in the large intestine, the combination of the two may have a synergistic effect to improve the gut health The stimulation of probiotics with pre-biotics leads to the regulation of intestinal metabolic activity while maintaining the intestinal biostructure, forming beneficial bacteria, and suppressing potential pathogens in the gastrointestinal tract Therefore, when combining the pre-biotic formula, it is necessary to determine the characteristics of the pre-biotics that have a beneficial effect on the probiotics The use of synbiotics results in a significant increase in the levels of SCFAs, ketones, carbon disulfides and methyl acetates A study 73 has reported that Lactobacillus acidophilus DSM induced Several studies revealed that synbiotics have a positive effect on blood glycemic control 74 — Meanwhile, synbiotics have been observed to have a more significant effect on blood glycemic control and inflammation than the use of probiotics alone A similar result was confirmed in the prediabetic population, Kassian et al. The findings suggest that a combination of probiotics and pre-biotics in the synbiotics supplementation is more effective than probiotics alone in glycemic control. Furthermore, synbiotics resulted in a higher reduction in HOMA-IR and an elevation in the QUIKI, although there was no difference in microbial abundance. However, the disadvantage of using synbiotics is that it is difficult to predict the selectivity and specificity of each component and what the resulting mechanism of action will be. Of the included studies, only three reported that the use of probiotics 37 and pre-biotics 34 , 36 did not cause adverse reactions. However, in the current studies on pre-diabetes, although -biotics can alter the abundance of microbial populations, there is insufficient evidence to show significant benefits on glucose metabolism, lipid metabolism and body composition. In addition, the limited source of studies, the small sample size of each study, and the different study designs lead to inconsistent outcomes of glycemic control, pancreas islet function, changes in gut microbiota composition and other indicators between included studies. Therefore, in future researches, more and larger studies should be conducted to provide favorable evidence for -biotics to improve pre-diabetes, thereby providing a new therapeutic tool to prevent and delay the development of pre-diabetes to T2D. XW and JY conceived the idea and drafted the initial manuscript. XW, JY, and XQ designed the review. QW, ML, and DZ reviewed scoping searches and contributed to the methodological development of the review. All the authors XQ, QW, ML, and DZ revised the manuscript. All the authors have given approval of publishing. QC is the review guarantor. This work is supported by the Applied Basic Research Program YJ from the Department of Science and Technology of Sichuan Province. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Federation ID. IDF Diabetes Atlas 9th Edition International Diabetes Federation PubMed Abstract. Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care. doi: CrossRef Full Text Google Scholar. WHO IDF. Geneva: World Health Organization Ferrannini E, Gastaldelli A, Iozzo P. Pathophysiology of prediabetes. Med Clin North Am. Brannick B, Wynn A, Dagogo-Jack S. Prediabetes as a toxic environment for the initiation of microvascular and macrovascular complications. Exp Biol Med Maywood. PubMed Abstract CrossRef Full Text Google Scholar. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. National Diabetes Statistics Report. |
| What are the Best Probiotics for Managing Type 2 Diabetes? | Probiotics for diabetes management core gut Dehydration and the immune system, energy balance and Probiotics for diabetes management. Publish with us Policies and ethics. Discussion In the present maangement, we diaabetes to evaluate managemet effects of Probiitics on BMI and metabolic parameters in patients with type 2 diabetes mellitus. Lactobacillus and Bifidobacteriumtypes of vehicle used to deliver the probiotics food vs. Don't have an account? J Diabetes Metab Disord —8 Google Scholar Mohamadshahi M, Veissi M, Haidari F, Shahbazian H, Kaydani G-A, Mohammadi F Effects of probiotic yogurt consumption on inflammatory biomarkers in patients with type 2 diabetes. |
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