Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials

Abstract

This meta-analysis examined the effect of probiotics on glucose and glycaemic factors in diabetes and its associated risk factors. All randomised-controlled trials published in English in multiple databases from January 2000 to June 2015 were systematically searched. Only studies that addressed glucose-and glycaemic-related factors as outcome variables were included. The main outcomes of interest in trials were mean changes in glucose, HbA1c, insulin and homoeostasis model assessment-estimated insulin resistance (HOMA-IR). Using the Physiotherapy Evidence Database (PEDro) scale to assess the quality of studies, a total of eleven studies with 614 subjects were included. The pooled mean difference and effect size with a 95 % CI were extracted using a random-effect model. It was found that there are statistically significant pooled mean differences between the probiotics and the placebo-controlled groups on the reduction of glucose (−0·52 mmol/l, 95 % CI −0·92, −0·11 mmol/l; P = 0·01) and HbA1c (−0·32 %, 95 % CI −0·57, −0·07 %; P = 0·01). There was no statistically significant pooled mean difference between the probiotics and the placebo-controlled groups on the reduction of insulin (−0·48 µIU/ml, 95 % CI −1·34, 0·38 µIU/ml; P = 0·27) and HOMA-IR (pooled effect of -0·44, 95 % CI −1·57, 0·70; P = 0·45). Meta-regression analysis identified that probiotics had significant effects on reduction of glucose, HbA1c, insulin and HOMA-IR in participants with diabetes, but not in participants with other risk factors. The present meta-analysis suggested that probiotics may be used as an important dietary supplement in reducing the glucose metabolic factors associated with diabetes.

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

“…Our results statistically supported the conclusions that probiotic consumption resulted in an overall reduction in glucose and HbA 1c , which were consist with the conclusions in a previous review [28]. However, the effect on insulin showed a lack of accordance with the review by Sun, for our results revealed that probiotics also had a significant effect on insulin, but only for T2DM patients and not for other MS patients.…”

“…To assess the source of heterogeneity, subgroup analysis identified that probiotics had a significant effect on the reduction of insulin in T2DM patients, with a pooled standardized mean difference of −0.36 (95% CI −0.60, −0.12; p = 0.003) and no heterogeneity (I p = 0.96). However, there was no significant reduction in the trials among participants with other MS patients or other health conditions (generally defined as MS) with a pooled mean difference of −0.63 (95% CI −1.36, −0.10; p = 0.09), which was inconsistent with the result from the review of Sun [28] (Figure 3 A meta-analysis comparing probiotics to control groups showed obvious significance on the reduction of HbA 1c , as the pooled standardized mean difference was −0. reported LDL-C and HDL-C values.…”

“…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

“…As a long-term measure of glycaemia, the included intervention trials (mostly ≤ 8 weeks) may have been too short to show significant changes in HbA 1c . In contrast, Sun and Buys reported, in their metaanalysis of individuals with type 2 diabetes or with diabetes-associated risk factors, a significant reduction in the participants' HbA 1c following 6-12 weeks' probiotic intervention [29]. In their study, the glycaemiareducing effect of probiotics was most pronounced in those with diabetes, and when multiple strains were used.…”