Probiotics supplementation promising adjuvant therapy for patients with type 2 diabetes

The systematic review and meta-analysis revealed that Bifidobacterium and food-type probiotics had higher glucose-lowering effects than other probiotic genera and vehicle types used for probiotic delivery. Probiotic intervention may be of more benefit for patients with a higher BMI concerning glycemic control.

Type 2 diabetes accounts for about 90% of all diabetes cases, leading to life-threatening and costly complications and reduced life expectancy. There exists no radical cure for T2DM, and its treatment relies on the use of anti-diabetic drugs for the long term. Therefore, exploring new methods that may effectively delay or even reverse T2DM progression is essential.

Recent research has demonstrated that gut microbiota plays a critical role in maintaining host homeostasis and the pathogenesis of T2DM. Probiotics are microbial dietary supplements that modify the gut microbiota. Some RCTs (randomized controlled trials) have investigated the effects of probiotics on glycemic control in patients with type 2 diabetes. However, evidence is inconsistent from clinical trials on the effects of probiotics supplementation on blood sugar control.

Against the above background, Su-Mei Xiao, Sun Yat-Sen University, Guangzhou, China, and colleagues aimed to evaluate the effectiveness of probiotics supplementation on glycaemic control in type 2 diabetes patients based on the data from the RCTs.

For this purpose, the researchers searched the online databases from inception to October 2022 and collected RCTs about probiotics and T2DM. The standardized mean difference (SMD) was used to estimate the effects of probiotics supplementation on parameters related to glycemic control, e.g. insulin, fasting blood glucose (FBG), homeostasis model of assessment of insulin resistance (HOMA-IR), and haemoglobin A1c (HbA1c). The study identified thirty RCTs comprising 1,827 T2MD patients.

The authors reported the following findings:

• Compared with the placebo group, the probiotics supplementation group had a significant decrease in the parameters of glycaemic control, including FBG (SMD = − 0.331), insulin (SMD = − 0.185), HbA1c (SMD = − 0.421), and HOMA-IR (SMD = − 0.224).
• Further subgroup analyses showed that the effect was more significant in the subgroups of Caucasians, high baseline body mass index (BMI ≥ 30.0 kg/m2), Bifidobacterium and food-type probiotics.

"The results revealed that probiotic supplementation significantly decreased insulin, FBG, and HbA1c levels and HOMA-IR scores in type 2 diabetes patients," the authors conclude.

Reference:

Li, G., Feng, H., Mao, XL. et al. The effects of probiotics supplementation on glycaemic control among adults with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials. J Transl Med 21, 442 (2023). https://doi.org/10.1186/s12967-023-04306-0