Probiotics Contribute to Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Abstract

This systematic review aimed to evaluate the effectiveness and safety of probiotics for glycemic control in adults with impaired glucose control, including prediabetes and type 2 diabetes mellitus (T2DM). We searched PubMed, Embase, and Cochrane databases, and trial registries up to February 2019. We included randomized controlled trials (RCTs) of participants with prediabetes or T2DM. Eligible trials compared probiotics versus either placebo, no intervention, or comparison probiotics, or compared synbiotics versus prebiotics. Primary outcomes were mean change in fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) from baseline to short term (<12 wk) and long term (≥12 wk). We performed meta-analyses using the random-effects model. We included 28 RCTs (1947 participants). Overall, probiotics reduced FBG more than the placebo/no intervention group with a mean difference (MD) of –12.99 mg/dL (95% CI: –23.55, –2.42; P value: 0.016) over the short term; and –2.99 mg/dL (95% CI: –5.84, –0.13; P value: 0.040) over the long term. There was also some evidence for reduced HbA1c in the probiotics group at both short term (MD: –0.17; 95% CI: –0.37, 0.02; P value: 0.084) and long term (MD: –0.14; 95% CI: –0.34, 0.06; P value: 0.172), however, these did not reach statistical significance possibly because only a few trials reported HbA1c as an outcome. Subgroup analyses showed a greater reduction in HbA1c in participants not receiving insulin therapy than those receiving insulin therapy. Furthermore, the effect of probiotics on the reduction of FBG was more pronounced in participants with FBG >130 mg/dL and those not receiving insulin therapy than their counterparts. Probiotics were also effective in lowering serum cholesterol over the short and long term. In conclusion, we found that probiotics may have a glucose-lowering effect in T2DM participants. The effect appeared to be stronger in participants with poorly controlled diabetes and those not on insulin therapy. Systematic review registration: CRD42019121682.

Microbiome First Medicine in Health and Safety

“…Table 4 illustrates examples from human clinical trials [ 131 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 ]. Not surprisingly, the best outcomes occur when there is a clear understanding of the specific microbes, genes, metabolic changes, and installation conditions that are needed to support microbiome-driven physiological benefits.…”

Preventive Effect and Molecular Mechanism of Lactobacillus rhamnosus JL1 on Food-Borne Obesity in Mice

“…Both single and multi-bacterial species can significantly reduce body weight, TNF-α, insulin, total cholesterol, and low density lipid-cholesterol levels [8]. Probiotics can significantly reduce the fasting blood sugar of patients, and their effects are better than those obtained in patients without insulin therapy [9]. Probiotics can improve insulin sensitivity, reduce lipid levels and insulin resistance, and further alleviate cardiac dysfunction in mice on a high-fat diet [10].…”

Empfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus

“…Die Auswirkung einer Probiotika-Supplementation auf den T2Dm mellitus ist bereits umfassend untersucht worden. Diverse Metaanalysen zeigen eine signifikante Reduktion der Nüchternblutglukose bei T2Dm durch eine Probiotika-Supplementation, verglichen mit einer Placebogabe [289][290][291][292][293][294]. Auch eine signifikante Senkung der Insulinresistenz (HOMA-Index) wurde bei Probanden mit T2Dm infolge einer Probiotikagabe, verglichen mit der Kontrollgruppe, in mehreren Metaanalysen beobachtet [291,295].…”