Probiotics for the treatment of type 2 diabetes: A review of randomized controlled trials

Tiderencel, Kelly A.; Hutcheon, Deborah A.; Ziegler, Jane

doi:10.1002/dmrr.3213

Cited by 56 publications

(41 citation statements)

References 55 publications

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“…For example, T2D patients treated with acarbose showed increased L. gasseri levels, accompanied by lower HbA1C and body weights (32). In addition, as several species in the genus Lactobacillus have been used as probiotics, administration of these Lactobacillus strains showed beneficial effects on glycemic control and lipid profiles in T2D patients (4). Moreover, almost all animal studies that tested the efficacy of several species from the genus as probiotics for T2D reported improvements of glucose parameters (1).…”

Section: Discussionmentioning

confidence: 99%

“…From a clinical perspective, these findings provide a rationale for targeting gut microbiota imbalance as a potential strategy for T2D treatment by restoring a healthy gut microbiome, including fecal microbiota transplant and probiotic supplements (3,4). However, the efficiency and effectiveness of these treatments remain uncertain due to concerns over the invasive nature of fecal microbiota transplant and the dosage, species, and duration required for an effective probiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Non-insulin Anti-hyperglycemic Agents on Gut Microbiota: A Systematic Review on Human and Animal Studies

Cao

Hsu

et al. 2020

Front. Endocrinol.

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Background: As growing evidence links gut microbiota with the therapeutic efficacy and side effects of anti-hyperglycemic drugs, this article aims to provide a systematic review of the reciprocal interactions between anti-hyperglycemic drugs and gut microbiota taxa, which underlie the effect of the gut microbiome on diabetic control via bug-host interactions. Method: We followed the PRISMA requirements to perform a systematic review on human vs. animal gut microbiota data in PubMed, SCOPUS, and EMBASE databases, and used Cochrane, ROBIN-I, and SYRCLE tools to assess potential bias risks. The outcomes of assessment were trends on gut microbiota taxa, diversity, and associations with metabolic control (e.g., glucose, lipid) following anti-hyperglycemic treatment. Results: Of 2,804 citations, 64 studies (17/humans; 47/mice) were included. In human studies, seven were randomized trials using metformin or acarbose in obese, pre-diabetes, and type 2 diabetes (T2D) patients. Treatment of pre-diabetes and newly diagnosed T2D patients with metformin or acarbose was associated with decreases in genus of Bacteroides, accompanied by increases in both Bifidobacterium and Lactobacillus. Additionally, T2D patients receiving metformin showed increases in various taxa of the order Enterobacteriales and the species Akkermansia muciniphila. Of seven studies with significant differences in beta-diversity, the incremental specific taxa were associated with the improvement of glucose and lipid profiles. In mice, the effects of metformin on A. muciniphila were similar, but an inverse association with Bacteroides was reported. Animal studies on other anti-hyperglycemic drugs, however, showed substantial variations in results. Cao et al. Anti-hyperglycemic Drugs and Gut Microbiota Conclusions: The changes in specific taxa and β-diversity of gut microbiota were associated with metformin and acarbose in humans while pertinent information for other anti-hyperglycemic drugs could only be obtained in rodent studies. Further human studies on anti-hyperglycemic drugs other than metformin and acarbose are needed to explore gut microbiota's role in their therapeutic efficacies and side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Non-insulin Anti-hyperglycemic Agents on Gut Microbiota: A Systematic Review on Human and Animal Studies

Cao

Hsu

et al. 2020

Front. Endocrinol.

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“…GLP1 is an antidiabetic hormone involved in glucose homeostasis, and reduction of glucagon secretion and appetite (337)(338)(339). Many probiotics improve glucose metabolism (340) and inhibit NF-κB pathway overactivation. NF-κB is associated with diabetes and its inhibition leads to improvement in insulin sensitivity (94,309).…”

Section: Probiotics Therapies In Non-infectious Disordersmentioning

confidence: 99%

Modulatory Effects of Probiotics During Pathogenic Infections With Emphasis on Immune Regulation

et al. 2021

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In order to inhibit pathogenic complications and to enhance animal and poultry growth, antibiotics have been extensively used for many years. Antibiotics applications not only affect target pathogens but also intestinal beneficially microbes, inducing long-lasting changes in intestinal microbiota associated with diseases. The application of antibiotics also has many other side effects like, intestinal barrier dysfunction, antibiotics residues in foodstuffs, nephropathy, allergy, bone marrow toxicity, mutagenicity, reproductive disorders, hepatotoxicity carcinogenicity, and antibiotic-resistant bacteria, which greatly compromise the efficacy of antibiotics. Thus, the development of new antibiotics is necessary, while the search for antibiotic alternatives continues. Probiotics are considered the ideal antibiotic substitute; in recent years, probiotic research concerning their application during pathogenic infections in humans, aquaculture, poultry, and livestock industry, with emphasis on modulating the immune system of the host, has been attracting considerable interest. Hence, the adverse effects of antibiotics and remedial effects of probiotics during infectious diseases have become central points of focus among researchers. Probiotics are live microorganisms, and when given in adequate quantities, confer good health effects to the host through different mechanisms. Among them, the regulation of host immune response during pathogenic infections is one of the most important mechanisms. A number of studies have investigated different aspects of probiotics. In this review, we mainly summarize recent discoveries and discuss two important aspects: (1) the application of probiotics during pathogenic infections; and (2) their modulatory effects on the immune response of the host during infectious and non-infectious diseases.

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“…Most evidence of PB-related benefits has been demonstrated in the treatment or management of specific pathologies [105][106][107][108]. Studies evaluating the immunomodulatory efficacy and potential prophylactic activity of PBs in non-diseased subjects are minimal.…”

Section: Probioticsmentioning

confidence: 99%

Microbiota Modulating Nutritional Approaches to Countering the Effects of Viral Respiratory Infections Including SARS-CoV-2 through Promoting Metabolic and Immune Fitness with Probiotics and Plant Bioactives

et al. 2020

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Viral respiratory infections (VRIs) can spread quickly and cause enormous morbidity and mortality worldwide. These events pose serious threats to public health due to time lags in developing vaccines to activate the acquired immune system. The high variability of people’s symptomatic responses to viral infections, as illustrated in the current COVID-19 pandemic, indicates the potential to moderate the severity of morbidity from VRIs. Growing evidence supports roles for probiotic bacteria (PB) and prebiotic dietary fiber (DF) and other plant nutritional bioactives in modulating immune functions. While human studies help to understand the epidemiology and immunopathology of VRIs, the chaotic nature of viral transmissions makes it difficult to undertake mechanistic study where the pre-conditioning of the metabolic and immune system could be beneficial. However, recent experimental studies have significantly enhanced our understanding of how PB and DF, along with plant bioactives, can significantly modulate innate and acquired immunity responses to VRIs. Synbiotic combinations of PB and DF potentiate increased benefits primarily through augmenting the production of short-chain fatty acids (SCFAs) such as butyrate. These and specific plant polyphenolics help to regulate immune responses to both restrain VRIs and temper the neutrophil response that can lead to acute respiratory distress syndrome (ARDS). This review highlights the current understanding of the potential impact of targeted nutritional strategies in setting a balanced immune tone for viral clearance and reinforcing homeostasis. This knowledge may guide the development of public health tactics and the application of functional foods with PB and DF components as a nutritional approach to support countering VRI morbidity.

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Probiotics for the treatment of type 2 diabetes: A review of randomized controlled trials

Cited by 56 publications

References 55 publications

Effects of Non-insulin Anti-hyperglycemic Agents on Gut Microbiota: A Systematic Review on Human and Animal Studies

Effects of Non-insulin Anti-hyperglycemic Agents on Gut Microbiota: A Systematic Review on Human and Animal Studies

Modulatory Effects of Probiotics During Pathogenic Infections With Emphasis on Immune Regulation

Microbiota Modulating Nutritional Approaches to Countering the Effects of Viral Respiratory Infections Including SARS-CoV-2 through Promoting Metabolic and Immune Fitness with Probiotics and Plant Bioactives

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