Probiotics for the management of type 2 diabetes mellitus: A systematic review and meta-analysis

Samah, Syamimi; Ramasamy, Kalavathy; Lim, Siong Meng; Neoh, Chin Fen

doi:10.1016/j.diabres.2016.06.014

Cited by 93 publications

(58 citation statements)

References 41 publications

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“…However, the 20 RCTs that they included had mean age ranging from 6 months to 85 years, some of them had short follow-up (7 days), and also involved participants with acute inflammation. Other meta-analyses on patients with T2DM did not support a significant effect of probiotics on IL-6 and CRP levels (Samah et al, 2016; Yao et al, 2017). Perhaps the anti-inflammatory action of probiotics is stronger in specific conditions (i.e., acute disease or chronic LGI compared to others) or is dependent on the strain of microorganisms.…”

Section: Discussionmentioning

confidence: 97%

Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis

Custodero

Mankowski

Lee

et al. 2018

Ageing Research Reviews

129

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Growing evidence suggests chronic low-grade inflammation (LGI) as a possible mechanism underlying the aging process. Some biological and pharmaceutical compounds may reduce systemic inflammation and potentially avert functional decline occurring with aging. The aim of the present meta-analysis was to examine the association of pre-selected interventions on two established biomarkers of inflammation, interleukin-6 (IL-6), and C-reactive protein (CRP) in middle-age and older adults with chronic LGI. We reviewed the literature on potential anti-inflammatory compounds, selecting them based on safety, tolerability, acceptability, innovation, affordability, and evidence from randomized controlled trials. Six compounds met all five inclusion criteria for our systematic review and meta-analysis: angiotensin II receptor blockers (ARBs), metformin, omega-3, probiotics, resveratrol and vitamin D. We searched in MEDLINE, PubMed and EMBASE database until January 2017. A total of 49 articles fulfilled the selection criteria. Effect size of each study and pooled effect size for each compound were measured by the standardized mean difference. I2 was computed to measure heterogeneity of effects across studies. The following compounds showed a significant small to large effect in reducing IL-6 levels: probiotics (−0.68 pg/ml), ARBs (−0.37 pg/ml) and omega-3 (−0.19 pg/ml). For CRP, a significant small to medium effect was observed with probiotics (−0.43 mg/L), ARBs (−0.2 mg/L), omega-3 (−0.17 mg/L) and metformin (−0.16 mg/L). Resveratrol and vitamin D were not associated with any significant reductions in either biomarker. These results suggest that nutritional and pharmaceutical compounds can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. The findings should be interpreted with caution, however, due to the evidence of heterogeneity across the studies.

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Section: Discussionmentioning

confidence: 97%

Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis

Custodero

Mankowski

Lee

et al. 2018

Ageing Research Reviews

129

View full text Add to dashboard Cite

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“…Further research is therefore required before probiotics can be recommended to pregnant women to reduce their risk of GDM. A meta-analysis of six RCTs demonstrated a significant reduction in FBG in 252 subjects with type 2 diabetes [44], however changes in HbA1c, inflammatory markers, fasting insulin and HOMA-IR were inconclusive, possibly due to the brief duration of the intervention (4–8 weeks). It was also unknown whether trial participants were also receiving pharmacological therapy such as Metformin, which can influence the composition of the gut microbiota.…”

Section: Discussionmentioning

confidence: 99%

“…It was also unknown whether trial participants were also receiving pharmacological therapy such as Metformin, which can influence the composition of the gut microbiota. The authors postulated that probiotics may elicit hypoglycemic effects by increasing the level of antioxidative enzymes capable of scavenging reactive oxygen species, thereby reducing oxidative stress levels [44]. Similarly, a systematic review of 12 RCTs explored the effect of probiotics on glucose tolerance in people with type 2 diabetes, concluding that probiotic supplementation significantly reduced FBG [45].…”

Section: Discussionmentioning

confidence: 99%

Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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The metabolic effects of probiotic administration in women with gestational diabetes mellitus (GDM) is unknown. The objective of this review was to investigate the effect of probiotics on fasting plasma glucose (FPG), insulin resistance (HOMA-IR) and LDL-cholesterol levels in pregnant women diagnosed with GDM. Seven electronic databases were searched for RCTs published in English between 2001 and 2017 investigating the metabolic effects of a 6–8 week dietary probiotic intervention in pregnant women following diagnosis with GDM. Eligible studies were assessed for risk of bias and subjected to qualitative and quantitative synthesis using a random effects model meta-analyses. Four high quality RCTs involving 288 participants were included in the review. Probiotic supplementation was not effective in decreasing FBG (Mean Difference = −0.13; 95% CI −0.32, 0.06, p = 0.18) or LDL-cholesterol (−0.16; 95% CI −0.45, 0.13, p = 0.67) in women with GDM. However, a significant reduction in HOMA-IR was observed following probiotic supplementation (−0.69; 95% CI −1.24, −0.14, p = 0.01). There were no significant differences in gestational weight gain, delivery method or neonatal outcomes between experimental and control groups, and no adverse effects of the probiotics were reported. Probiotic supplementation for 6–8 weeks resulted in a significant reduction in insulin resistance in pregnant women diagnosed with GDM. The use of probiotic supplementation is promising as a potential therapy to assist in the metabolic management of GDM. Further high quality studies of longer duration are required to determine the safety, optimal dose and ideal bacterial composition of probiotics before their routine use can be recommended in this patient group.

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“…Numerous meta‐analyses suggest a beneficial effect of probiotics on glycaemic control in people with T2D . However, there is no consensus on the specific metabolic effect associated with supplementation.…”

Section: The Role Of Gut Microbiome In Obesity and Diabetesmentioning

confidence: 99%

Obesity and diabetes—Not only a simple link between two epidemics

Chobot¹,

Górowska-Kowolik²,

Sokołowska

et al. 2018

Diabetes Metabolism Res

230

158

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SummaryDiabetes (DM) as well as obesity, due to their increasing incidence, were recognized as epidemic by the World Health Organization. Obesity is involved not only in the aetiopathogenesis of the most common worldwide type of DM—type 2 diabetes—but also in the development of its complications. There is also increasing scientific evidence regarding the role of obesity and overweight in type 1 diabetes. Weight gain may be considered as a complication of insulin treatment but also reveals significant pathophysiological impact on various stages of the disease. Another very important aspect related to DM as well as obesity is the microbiome, which is highly variable. The function of the gut microflora, its interaction with the whole organism, and its role in the development of obesity and type 1 diabetes as well as type 2 diabetes are still not fully understood and subject of ongoing investigations. This review presents a summary of recently published results concerning the relation of obesity/overweight and DM as well as their associations with the microbiome.

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Probiotics for the management of type 2 diabetes mellitus: A systematic review and meta-analysis

Cited by 93 publications

References 41 publications

Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis

Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis

Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Obesity and diabetes—Not only a simple link between two epidemics

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