The effects of probiotics supplementation on glycaemic control among adults with type 2 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials.

Guang Li, Hao Feng, Xin-Liang Mao, Yan-Jun Deng, Xiao-Bao Wang, Qiong Zhang, Yan Guo, Su-Mei Xiao

Journal: Journal of translational medicine 2023;21(1):442

PMID: 37415167

Plain Language Summary

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Type 2 diabetes mellitus (T2DM), an endocrine and metabolic disease, is influenced by host physiology and environmental factors. Recent studies have shown that the gut microbiota plays a key role in the maintenance of host homeostasis and pathogenesis of T2DM. The aim of this study was to evaluate the effects of a probiotic intervention on glycaemic control in T2DM patients and to evaluate the variations in these effects due to participant characteristics and intervention characteristics. This study was a systematic review and meta-analysis of thirty randomised-controlled studies including a total of 1,827 individuals. Results showed that probiotic supplementation had favourable effects on glycaemic control in T2DM patients. Bifdobacterium and food-type probiotics had greater glucose-lowering effects than other probiotic genera and types of vehicles used to deliver the probiotics. Authors concluded that the administration of probiotics may be a promising adjuvant therapy for glycaemic control in T2DM patients.

Abstract

OBJECTIVE

This systematic review and meta-analysis study aimed to evaluate the effectiveness of probiotics supplementation on glycaemic control in patients with type 2 diabetes mellitus (T2DM) based on the data from the randomised clinical trials (RCTs).

METHODS

PubMed, Web of Sciences, Embase, and Cochrane Library were searched from the inception to October 2022, and RCTs about probiotics and T2DM were collected. The standardised mean difference (SMD) with 95% confidence interval (CI) was used to estimate the effects of probiotics supplementation on glycaemic control related parameters, e.g. fasting blood glucose (FBG), insulin, haemoglobin A1c (HbA1c), and homeostasis model of assessment of insulin resistance (HOMA-IR).

RESULTS

Thirty RCTs including 1,827 T2MD patients were identified. Compared with the placebo group, the probiotics supplementation group had a significant decrease in the parameters of glycaemic control, including FBG (SMD = - 0.331, 95% CI  - 0.424 to - 0.238, P < 0.001), insulin (SMD = - 0.185, 95% CI  - 0.313 to - 0.056, P = 0.005), HbA1c (SMD = - 0.421, 95% CI  - 0.584 to - 0.258, P < 0.001), and HOMA-IR (SMD = - 0.224, 95% CI  - 0.342 to - 0.105, P < 0.001). Further subgroup analyses showed that the effect was larger in the subgroups of Caucasians, high baseline body mass index (BMI ≥ 30.0 kg/m), Bifidobacterium and food-type probiotics (P < 0.050).

CONCLUSION

This study supported that probiotics supplementation had favourable effects on glycaemic control in T2DM patients. It may be a promising adjuvant therapy for patients with T2DM.

© 2023. The Author(s).

Address: Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; College of Food Science and Engineering, South China University of Technology, Guangzhou, 510640, China.; Zhongshan Center for Disease Control and Prevention, Zhongshan, 528403, China.; Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. [email protected].; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. [email protected].

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