Effects of Prebiotic and Synbiotic Supplementation on Glycaemia and Lipid Profile in Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials

Abstract

Purpose: Diabetes Mellitus (T2DM) as a chronic disease, is on rise in parallel with other non-communicable diseases. Several studies have shown that probiotics and prebiotics might exert beneficial effects in chronic diseases including diabetes. Because of controversial results from different trials, the present study aims to assess the effects of prebiotic/synbiotic consumption on metabolic parameters in patients with type2 diabetes.Methods: A systematic literature search was performed on randomized controlled trial published in PubMed/Medline, SciVerse Scopus, Google scholar, SID and Magiran up to March 2018. Of a total number of 255 studies found in initial literature search, ten randomized controlled trials were included in the meta-analysis. The pooled mean net change were calculated in fasting blood-glucose [FBG], Hemoglobin A1c [HbA1c] and lipid markers (total cholesterol [TC], triglyceride [TG], low-density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C]). The meta-analyses was conducted using Revman Software (v5.3).Results: The pooled estimate indicated a significant difference for the mean change in FBG, HbA1c and HDL in treatment group in comparison with control group. Subgroup analysis by intervention showed a significant difference in TG, LDL and HDL (synbiotic group) and in TG, TC, FBG, HDL and HbA1c (prebiotic group) compared with placebo. In another subgroup analysis, high quality studies showed significant reductions in TG, TC, FBG and HbA1c in intervention group compared with placebo group.Conclusion: In summary, diets supplemented with either prebiotics or synbiotics can result in improvements in lipid metabolism and glucose homeostasis in type 2 diabetic patients.

The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics

“…Numerous randomized controlled trials (RCTs) in humans across a range of populations, from healthy individuals to those with acute and chronic diseases, have been conducted to examine the health benefits of putative synbiotics. Many trials have been conducted in adults with metabolic diseases, including overweight and obesity 21 , 22 , type 2 diabetes mellitus 23 , 24 and non-alcoholic fatty liver disease 25 , 26 . Other outcomes, such as irritable bowel syndrome 27 , surgical infections 28 , 29 , chronic kidney disease 30 , 31 and atopic dermatitis 32 , have also been investigated.…”

Prevention and Treatment of Atherosclerosis: The Use of Nutraceuticals and Functional Foods

“…Prebiotics such as inulin and fructooligosaccharides are soluble, indigestible, viscous, and fermentable compounds that might play hypocholesterolemic actions either by decreasing cholesterol absorption and increasing its fecal excretion (similar to fiber as discussed above) or via production of short-chain fatty acids after their fermentation by the microbiota. The use of synbiotics is, thus, often advocated for cholesterol control (Mahboobi et al 2018).…”

The effects of synbiotic supplementation on metabolic factors and systemic inflammation in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled study

“…The findings of this study are comparable to the present study. In another study by Mahboobie et al [36] synbiotic supplements containing 6 bacterial strains with fructooligosaccharide for 12 weeks in person with diabetes. In this study, systolic and diastolic blood pressure did not change significantly in the intervention group compared to the placebo group.…”