The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials

Paul, Pradipta; Kaul, Ridhima; Harfouche, Manale; Arabi, Maryam; Al-Najjar, Yousef; Sarkar, Aparajita; Saliba, Reya; Châari, Ali

doi:10.1016/j.phrs.2022.106520

Cited by 21 publications

(20 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A meta-analysis focusing on dietary interventions (58 trials) with the potential to modulate the gut microbiome: prebiotics, probiotics (11 studies), and symbiotics and their effects on glucose metabolism, pointed association with fasting glycemia and insulinemia, and consequently with HOMA-IR; HbA1c was also affected by the dietary intervention [35].…”

Section: Dietary Fibers and Microbiomementioning

confidence: 99%

Carbohydrates for glycemic control: functional and microbiome aspects

Sardá

Giuntini

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

View full text Add to dashboard Cite

Purpose of reviewGlycemia goals are used as indicators of control and progression in prediabetes and diabetes. Adopting healthy eating habits is essential. It is worth considering the quality of carbohydrates to help with dietary glycemic control. The present article aims to review recent meta-analyses published in the years 2021–2022 on the effects of dietary fiber and low glycemic index/load (LGI/LGL) foods on glycemic control and how gut microbiome modulation contributes to glycemic control.Recent findingsData involving more than 320 studies were reviewed. The evidence allows us to infer that LGI/LGL foods, including dietary fiber intake, are associated with reduced fasting glycemia and insulinemia, postprandial glycemic response, HOMA-IR, and glycated hemoglobin, which are more evident in soluble dietary fiber. These results can be correlated with changes in the gut microbiome. However, the mechanistic roles of microbes or metabolites implicated in these observations continue to be explored. Some controversial data highlight the need for more homogeneity between studies.SummaryThe properties of dietary fiber are reasonably well established for their glycemic homeostasis effects, including the fermentation aspects. Findings of gut microbiome correlations with glucose homeostasis can be incorporated into clinical nutrition practice. Target dietary fiber interventions on microbiome modulation can offer options to improve glucose control and contribute to personalized nutritional practices.

show abstract

Section: Dietary Fibers and Microbiomementioning

confidence: 99%

Carbohydrates for glycemic control: functional and microbiome aspects

Sardá

Giuntini

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

View full text Add to dashboard Cite

show abstract

“…However, the results from studies are conflicting. Probiotics may also help restore metabolic homeostasis, e.g., improve body mass index (BMI), lipid profile, and glucose metabolism [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Nevertheless, they seem to offer little benefit regarding metabolic abnormalities [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

PRO-DEMET Randomized Controlled Trial on Probiotics in Depression—Pilot Study Results

et al. 2023

View full text Add to dashboard Cite

There is a pressing need to identify new treatment options for depression and its comorbidities. Depression often coexists with metabolic complications, and the two may share a pathophysiological overlap, including inflammation and microbiota changes. Microbiota interventions (e.g., probiotics) may represent a safe and easy-to-use treatment option as an adjunctive therapy in patients only partially responsive to pharmacologic treatment. (1) Objective: The paper presents the results of a feasibility and pilot study. The study is an internal part of a randomized controlled trail (RCT) of the effect of probiotic supplementation on psychometric, anthropometric, metabolic, and inflammatory parameters in adult patients with depressive disorders depending on the presence of metabolic syndrome. (2) Methods: The trial has a four-arm, parallel-group, prospective, randomized, double-blind, controlled design. Sixty participants received a probiotic preparation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 over 60 days. The feasibility of the study design was assessed, as well as the rates of recruitment, eligibility, consent, and study completion. The following were assessed: depressive, anxiety and stress symptoms, quality of life, blood pressure, body mass index and waist circumference, complete blood count with differential, serum levels of C-reactive protein, high-density lipoprotein cholesterol, triglycerides, fasting glucose, some secondary markers of inflammation and metabolic health, as well as noninvasive biomarkers of liver fibrosis (APRI and FIB-4). (3) Results: The study was found to be generally feasible. The eligibility rate was 52% of recruited participants with 80% completing the study protocol. No differences in sociodemographic or anthropometric factors or basic laboratory findings were found between the placebo and probiotic group at the start of the intervention period. Importantly, the proportion of recruited participants fulfilling the criteria of metabolic syndrome was too low. (4) Conclusions: Whilst the whole study protocol was feasible, some different timepoint procedures require modification. The major weakness of the recruitment methods was that the percentage of metabolic arms participants was insufficient. Overall, the full RCT design on probiotics in depression with vs. without metabolic syndrome was shown to be feasible with little modification.

show abstract

“…17,18 When used in combination, they are termed synbiotics. With recent links between dysbiosis of the gut and pathology diseases garnering traction across multiple research fields, 19 the potential of homoeostasis modulation of the gut via various nutraceuticals or faecal microbial transplants to ameliorate various metabolic, [20][21][22] neurological, oncological and inflammatory disorders has also garnered interest. [23][24][25][26][27][28][29][30][31][32] Although our understanding of the microbiome increases daily, its therapeutic use still requires considerable undertaking.…”

Section: Introductionmentioning

confidence: 99%

Microbiome‐modulating nutraceuticals ameliorate dyslipidemia in type 2 diabetes: A systematic review, meta‐analysis, and meta‐regression of clinical trials

Kaul

Paul

Harfouche

et al. 2023

Diabetes Metabolism Res

Self Cite

View full text Add to dashboard Cite

AimsType 2 Diabetes is intrinsically linked to cardiovascular disease (CVD) via diabetic dyslipidemia, both of which remain global health concerns with annually increasing prevalence. Given the established links between gut microbiome dysbiosis and metabolic diseases, its modulation is an attractive target to ameliorate metabolic imbalances in such patients. There is a need to quantitively summarise, analyse, and describe future directions in this field.MethodsWe conducted a systematic review, meta‐analysis, and meta‐regression following searches in major scientific databases for clinical trials investigating the effect of pro/pre/synbiotics on lipid profile published until April 2022. Data were pooled using random‐effects meta‐analysis and reported as mean differences with 95% confidence intervals (CIs). PROSPERO No. CRD42022348525.ResultsData from 47 trial comparisons across 42 studies (n = 2692) revealed that, compared to placebo/control groups, the administration of pro/pre/synbiotics was associated with statistically significant changes in total cholesterol (−9.97 mg/dL [95% CI: −15.08; −4.87], p < 0.0001), low‐density lipoprotein (−6.29 mg/dL [95% CI: −9.25; −3.33], p < 0.0001), high‐density lipoprotein (+3.21 mg/dL [95% CI: 2.20; 4.22], p < 0.0001), very‐low‐density lipoprotein (−4.52 mg/dL [95% CI: −6.36; −2.67], p < 0.0001) and triglyceride (−22.93 mg/dL [95% CI: −33.99; −11.87], p < 0.001). These results are influenced by patient characteristics such as age or baseline BMI, and intervention characteristics such as dosage and duration.ConclusionsOur study shows that adjunct supplementation with a subset of pro/pre/synbiotics ameliorates dyslipidemia in diabetic individuals and has the potential to reduce CVD risk. However, widespread inter‐study heterogeneity and the presence of several unknown confounders limit their adoption in clinical practice; future trials should be designed with these in mind.

show abstract

The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials

Cited by 21 publications

References 101 publications

Carbohydrates for glycemic control: functional and microbiome aspects

Carbohydrates for glycemic control: functional and microbiome aspects

PRO-DEMET Randomized Controlled Trial on Probiotics in Depression—Pilot Study Results

Microbiome‐modulating nutraceuticals ameliorate dyslipidemia in type 2 diabetes: A systematic review, meta‐analysis, and meta‐regression of clinical trials

Contact Info

Product

Resources

About