Effectiveness of probiotics in type 2 diabetes: a meta-analysis

Abstract

INTROduCTION An increasing number of studies suggest that the use of probiotics may have a beneficial effect in patients with type 2 diabetes.ObjECTIvEs The aim of the study was to assess the ability of probiotics to modify selected cardiometabolic risk factors in subjects with type 2 diabetes.METhOds PubMed, Embase, Cochrane Library, and Scopus databases were thoroughly reviewed up to January 2015 to search for randomized controlled trials (RCTs) that examined the effect of probiotics on selected modifiable cardiometabolic parameters in patients with type 2 diabetes. The following endpoints were considered: fasting plasma glucose (FPG), insulin concentration, insulin resistance, hemoglobin A 1c (HbA 1c ), as well as the levels of total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterols, and C-reactive protein (CRP). A total of 571 RCTs were initially identified, of which 8 trials with 438 individuals were selected for meta-analysis. The effects of probiotics were calculated for each parameter. REsuLTsThe meta-analysis showed a significant effect of probiotics on reducing HbA 1c levels (standardized mean difference [SMD], -0.81; confidence interval [CI], -1.33 to -0.29, P = 0.0023; I 2 = 68.44%; P = 0.0421 for heterogeneity) and HOMA-IR (SMD, -2.10; CI -3.00 to -1.20, P <0.001; I 2 = 82.91%; P = 0.0029 for heterogeneity). Supplementation with probiotics did not have a significant effect on FPG, insulin, and CRP levels as well as the lipid profile.CONCLusIONs Our meta-analysis suggests that probiotic supplementation might improve, at least to some extent, metabolic control in subjects with type 2 diabetes. However, larger well-designed, longterm RCTs are needed to confirm any potentially beneficial relationship between the use of probiotics and modifiable cardiometabolic risk factors in patients with type 2 diabetes.

Multiple effects of probiotics on different types of diabetes: a systematic review and meta-analysis of randomized, placebo-controlled trials

“…Many studies have assessed the effect of probiotics on metabolic profiles in people [39], and several systematic reviews and meta-analyses have shown that probiotics had an effect on diabetes, but their pooled results showed a lack of accordance and their included studies were uncomprehensive, which could lead to a possibility of unreliable results and conclusions [27][28][29]. Thus, we performed this meta-analysis demonstrate the effects of probiotics for T2DM and other MS patients in reducing the level of fasting glucose, insulin and HbA 1c .…”

“…In addition, some of the studies have not shown a positive curative effect and their conclusions still remain controversial, for some studies gave negative results [12,22]. Previous systematic reviews and meta-analyses have shown that probiotics had an effect on diabetes, but their pooled results showed a lack of accordance and their included studies were uncomprehensive, which could lead to a possibility of unreliable results and conclusions [27][28][29].…”

The Self-reported Use of Probiotics is Associated with Better Glycaemic Control and Lower Odds of Metabolic Syndrome and its Components in Type 1 Diabetes

“…It has been suggested that the SCFAs, produced by the beneficial gut microbes, may prevent low-grade inflammation via maintaining intestinal integrity [35]. A meta-analysis of the ability of probioticsintervention to reduce CRP levels, in type 2 diabetes, showed an overall non-significant effect [35].…”

“…A meta-analysis of the ability of probioticsintervention to reduce CRP levels, in type 2 diabetes, showed an overall non-significant effect [35]. A sub-group analysis in another metaanalysis suggested, however, that a high probiotic dose, longer intervention duration, and the use of multiple strains of probiotics would, indeed, have anti-inflammatory effects [36].…”

Potential mechanisms linking probiotics to diabetes: a narrative review of the literature

“…4 A growing body of evidence suggests that favorable associations exist between probiotic consumption and metabolic profile among diabetes subjects. 5 However, the potential mechanisms secretion from enteroendocrine L-cells to improve carbohydrate metabolism, decrease glucotoxicity and increase insulin sensitivity of target cells. 6 Other proposed mechanisms to explain the action of probiotics on diabetes relate to anti-inflammatory, antioxidant and immunomodulatory effects and alteration of the expression of some genes involved in diabetes.…”