In a recent study published in the journal Clinical Nutrition, researchers analyzed data from randomized clinical trials (RCTs) that investigated the effects of prebiotics and symbiotics on glycemic control in patients with type 1 and type 2 diabetes.
The global prevalence of both T1D and T2D continues to increase each year. Current estimates indicate that approximately 465 million adults aged 20–79 years worldwide are currently living with diabetes, with up to 578 and 700 million expected to be diagnosed by 2030 and respectively 2045.
Despite recent advances in antidiabetic treatments, a significant proportion of patients continue to experience suboptimal glycemic control. Among various new strategies for glycemic control, targeting the gut microbiota through probiotics and other therapies has been proposed as a novel approach to diabetes management.
In T1D, which is related to insulin deficiency, and T2D, which occurs due to insulin resistance, specific changes in the composition and function of the gut microbiota, which are collectively called gut dysbiosis, have been reported. Probiotics are live microorganisms that are associated with numerous health benefits through their ability to restore gut microbiota homeostasis, improve gastrointestinal (GI) tract integrity, and reduce inflammation.
Symbiotics, which are combinations of probiotics and prebiotics, are also gaining attention in the field of diabetes management for increasing the beneficial microorganisms present in the gastrointestinal tract.
For the current study, researchers used various electronic databases to identify relevant RCTs that included adult patients with diabetes who were treated with probiotics or symbiotics in addition to their specific antidiabetic treatments.
RCTs that compared these interventions with other treatments, placebo or standard diabetes care in the context of glycemic control were included in the meta-analysis. A total of 41 RCTs, involving 2,991 patients, were included in the final analysis. The various parameters that were evaluated to measure glycemic control included glycated hemoglobin (HbA1C), fasting plasma glucose, and serum insulin levels.
Study findings
The current meta-analysis showed that supplementation with probiotics and symbiotics is associated with significant improvements in fasting plasma glucose, serum insulin and HbA1C levels. Subgroup analysis demonstrated that the effectiveness of the interventions tested varied by the type of microbial strains used and between.
Multi-species formulas were associated with superior efficacy in improving HbA1C levels compared to single-species formulas. This observation emphasizes the importance of multispecies formulas in achieving persistent glycemic control.
Comparatively, single-species formulas were associated with more consistent effects on various outcomes, thus suggesting their wider applicability in diabetes management. Symbiotics were also associated with greater efficacy than probiotics in improving serum insulin levels.
Regarding the different types of bacterial species used in probiotic formulas, certain strains of Lactobacillus and Bifidobacterium lactis have been associated with pronounced effects, especially in multi-species formulas. Thus, the therapeutic efficacy of probiotic interventions for diabetes management may be strain-specific.
Limitations of the study
Moderate heterogeneity was observed within the selected RCTs, which could be attributed to variations in study design, participant characteristics and intervention protocols. Importantly, this heterogeneity may limit the generalizability of the findings.
In addition, most of the selected RCTs were conducted in Iran, thus limiting the generalizability of these findings to other populations with different genetic and environmental factors.
Also, the current study could not determine the effectiveness of these interventions for each type of diabetes separately. T1D and T2D have distinct pathophysiologies, treatment modalities, and therapeutic outcomes; therefore, the effects of both probiotics and symbiotics on glycemic control may vary between patients with these different types of diabetes.
ConCluSIonS
The study results highlight the potential importance of both probiotics and symbiotics as complementary interventions in diabetes management. However, future studies that consider more variables, such as strain types and geographic factors, are needed to better understand the efficacy of probiotics and symbiotics in the management of T1D and T2D.
“While probiotics and symbiotics hold promise as adjunctive therapies, they are not a stand-alone solution in diabetes care… Incorporating probiotics or symbiotics into treatment may be a viable strategy for improving glycemic control, although more tailored research is needed .”
Source: News-medical.net
