Probiotics, prebiotics, and synbiotics in type 1 diabetes mellitus: A systematic review and meta‐analysis of clinical trials

Abstract

Dysbiosis or imbalance of microbes in the gut has been associated with susceptibility and progression of type 1 diabetes mellitus (T1DM). The present systematic review and meta‐analysis examined the effects of probiotics, prebiotics, and synbiotics on fasting blood glucose (FBG), haemoglobin A1c (HbA1c), C‐peptide, and insulin requirements in T1DM patients. A systematic search for trials published up to October 2022 was conducted in PubMed, EMBASE, Scopus, Google Scholar, ScienceDirect, Web of Science, and the Central Cochrane Library. Random effect models were used to synthesise quantitative data by STATA14. After the evaluation of 258 identified entries, five randomised controlled trials (n = 356; mean age = 11.7 years old) were included. The pooled effect size showed that FBG decreased following probiotic supplementation (weighted mean difference = −31.24 mg/dL; 95% confidence interval = −45.65, −16.83; p < 0.001), however, there was no significant improvement in serum HbA1c, C‐peptide, and insulin requirements. Probiotic supplementation could be a complementary therapeutic strategy in T1DM. The evidence is limited; therefore, it is crucial to conduct more trials.

The Effect of Microbiome-Modulating Agents (MMAs) on Type 1 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…While the moderate heterogeneity aligned with the literature [20], the combined effect varied, which might be attributed to the differentiation between T1D and T2D. This review further demonstrated an improvement in DIU and FCP, contradicting the negative results from another review [19]. Furthermore, three studies conducted post-interventional biochemical examinations, revealing no significant difference between the MMA and control groups [15,34,37].…”

“…Conversely, the literature specifically addressing T1D is notably limited, with only two existing reviews identified. One review, encompassing five randomized controlled trials (RCTs) up to 8 October 2022, examined the impact of probiotics and synbiotics on glycemic control, focusing on outcomes such as fasting blood glucose (FBG), HbA1c, fasting C-peptide (FCP), and daily insulin usage (DIU) [ 19 ]. However, it did not delve into the outcomes related to T1D pathogenesis, such as inflammatory cytokines and gut microbiota composition.…”

Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives

“…11 Finally, we have decided to include additional articles that do not necessarily relate to the topic of chrononutrition, but that we believe would still provide extremely important information in their related fields of dietetics, nutrition, and cardiometabolic diseases. These articles include discussions on the role of prebiotics, probiotics, and synbiotics, in patients with type 1 diabetes mellitus 12 the role of transitioning from a metabolically healthy obesity phenotype to a metabolically unhealthy obesity phenotypes on atherosclerotic risk and its related editorial written by experts in the field, 13,14 the role of pharmacologic and nutritional interventions in patients with post-bariatric surgery-related hypoglycaemia 15 and the effects of microbiome and nutraceutical in patients with type 2 diabetes. 16 In conclusion, this Special Issue will provide novel insights and clarifications on chrononutrition, but also on additional controversial topics.…”

Type 1 diabetes mellitus prevention

“…In secondary prevention, the use of probiotics/synbiotics was associated with reduction of pro-inflammatory cytokines (IL-1, IL-8, IL-17, MIP-1β, RANTES, and TNF-α), oxidative stress (hs-CRP), and an increase in total antioxidant capacity and the anti-inflammatory cytokine TGF-β1. Meta-analyses evaluating the effect of probiotics showed HbA1c and fasting blood glucose reduction [20][21][22].…”