Science Update

New Review Investigates the Metabolic Effects of Probiotics in Patients with Type 2 Diabetes

Type 2 diabetes affects more than 30 million individuals and the youth account for 20% to 50% of new onset diabetes cases.

According to a new study published this month in Scientific Reports, researchers investigated the cardiometabolic effects of probiotics in patients with Type 2 diabetes. These patients are at high risk of cardiovascular disease. Previous research demonstrated the association of the gut microbiome with metabolic markers and Type 2 diabetes.

This meta-analysis included 32 randomized, placebo-controlled trials and assessments, including body mass index (BMI), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein (CRP), HbA1c, fasting glucose, fasting insulin and blood pressure. Included in these studies were between 20 and 136 patients, each ranging from a duration of 4 to 43 weeks. Some studies used a single strain, multispecies or spores at doses with a minimum of 2 billion CFUs.

As a result, probiotic supplementation demonstrated a significant effect on reducing total cholesterol, triglyceride levels, CRP, HbA1c, fasting glucose, fasting insulin and blood pressure. In addition, probiotic supplementation also increased HDL levels, however, it did not have a significant affect on BMI or LDL cholesterol levels. These results demonstrate that probiotics can improve dyslipidemia and dysglycemia in patients with Type 2 diabetes.

These affects are due to the immunoregulatory properties of probiotics. In addition, low-grade inflammation by the gut promotes insulin resistance in the liver and the release of inflammatory mediators from the adipose tissue. Also, increased intestinal permeability allows translocation of pro-inflammatory lipopolysaccharides.

Furthermore, the gut microbiome is found to be different in patients with Type 2 diabetes compared to healthy individuals. For example, if one has more Bacteroidetes bacteria, the individual tends to be leaner. With high Firmicutes, Bacteroidetes ratios have been known to increase the caloric extraction from food, and these individuals tend to be more obese. In addition, the ratios of Bacteroidetes and Firmicutes have a positive correlation with decreased insulin resistance. This also ties together the importance of dietary fiber, prebiotics, probiotics and weight loss.

Probiotics help encourage microbial diversity, especially if the probiotic supplement consists of mixed species. In ecological terms, it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome. This meta-analysis demonstrates the potential benefits of probiotic supplementation in patients with Type 2 diabetes.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source:  Kocsis T, Molnár B, Németh D, et al. Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials. Sci Rep. 2020;10(1):11787.