Probiotics and synbiotics for glycemic control in diabetes: A systematic review and meta-analysis of randomized controlled trials.

Autor: Baroni I; Clinical Research Service, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy., Fabrizi D; Department of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy., Luciani M; Department of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy., Magon A; Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy., Conte G; Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy., De Angeli G; Clinical Research Service, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy., Paglione G; Clinical Research Service, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy., Ausili D; Department of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy., Caruso R; Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy. Electronic address: rosario.caruso@grupposandonato.it.
Jazyk: angličtina
Zdroj: Clinical nutrition (Edinburgh, Scotland) [Clin Nutr] 2024 Apr; Vol. 43 (4), pp. 1041-1061. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1016/j.clnu.2024.03.006
Abstrakt: Background & Aims: The escalating prevalence of diabetes mellitus may benefit from add-on therapeutic approaches. Given the recognized need for an updated synthesis of the literature, this systematic review and meta-analysis aimed to synthesize and critically assess the available randomized controlled trials (RCTs) that investigate the efficacy of probiotics and synbiotics on glycemic control in patients with Type 1 (T1DM) and Type 2 (T2DM) diabetes mellitus.
Methods: Comprehensive searches were conducted on PubMed, Embase, CINAHL, Scopus, and Web of Science, focusing on adults with T1DM or T2DM. All comparators were deemed eligible. Primary outcomes included changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and insulin levels. Only RCTs were included, and the Cochrane RoB2 tool assessed the risk of bias. Random-effect models facilitated data analysis, supplemented by sensitivity, subgroup analyses, and meta-regressions.
Results: A total of 537 records were screened, resulting in 41 RCTs for analysis, which comprises 2991 (54% females) patients with diabetes. The meta-analysis revealed statistically significant improvements in HbA1c (standardized mean difference (SMD) = -0.282, 95% CI: [-0.37, -0.19], p < 0.001), FPG (SMD = -0.175, 95% CI: [-0.26, -0.09], p < 0.001), and insulin levels (SMD = -0.273, 95% CI: [-0.35, -0.20], p < 0.001). A medium degree of heterogeneity between studies was found in HbA1c (I 2  = 62.5%), FPG (I 2  = 71.5%), and insulin levels (I 2  = 66.4%) analyses. Subgroup analyses indicated that the efficacy varied based on the type of strains used and the country. Multispecies strains were particularly effective in improving HbA1c levels.
Conclusion: The study findings suggest that probiotics and synbiotics may be effective as complementary therapies for managing diabetes. Additionally, the study underscores the need for further tailored research that considers variables such as strain types and geographical factors to deepen the understanding of the role of these interventions in diabetes care.
Review Registration Number: PROSPERO (CRD42023396348).
Competing Interests: Conflict of interest The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the article.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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