Type II diabetes (T2DM) is a popular metabolic disease, which has caused widespread concern due to its increasing incidence and more complications.
T2DM is characterized by elevated fasting blood glucose (FBG) and Glycated Hemoglobin (HbA1c), indicating that it is a symptom of abnormal glucose metabolism. Due to T2DM patients have a higher rate of gastrointestinal symptoms during the onset of the disease, such as gastroparesis, diarrhea, intestinal bacterial proliferation, celiac disease, and constipation. T2DM is thought to be caused by a series of multiple risk factors, such as genetic factors, age, overweight or obesity, and unhealthy lifestyles.
Recently, accumulated evidence indicates that the risk of developing T2DM may also involve factors in the gut microbiota.
Intestinal flora efficiency of food decomposition energy, the remaining time of food in the intestine, mucosal immunity, intestinal permeability, and systemic inflammation, etc., all of these factors are involved in triggering and the progression of type II diabetes, and recent research which was found that patients with T2DM had moderate intestinal microbial disorders.
A lot of scientific evidence from in vitro cell and animal studies shows that probiotics have the potential to prevent and reduce type II diabetes and other metabolic diseases. Considering the gastrointestinal symptoms of T2DM, the intestinal microbiota is thought to be involved in the pathogenesis of T2DM.
Dyslipidemia is a common symptom of T2DM, especially triglycerides (TG), which is also one of the main causes of cardiovascular complications in diabetic patients.
Probiotics are believed to have the function of lowering blood lipids in the host.
A clinical trial of pre-diabetic patients taking synbiotics (biological agents combined with probiotics and prebiotics) shows that pre-diabetic patients take daily intake Synbiotics 6g can reduce the triglyceride level of pre-diabetic patients after six months. This evidence can show that probiotics may have an effect on preventing cardiovascular disease in diabetic patients.
An increasing number of patients with T2DM do not respond well to antidiabetic drugs (such as metformin).
Therefore, there is an urgent need to develop new drugs and strategies to combat the occurrence and treatment of diabetes.
A case report of a poor response to antidiabetic drugs showed that after two patients were treated with probiotics, their fasting blood glucose (FBG) and Glycated Hemoglobin (HbA1c) were effectively reduced, indicating that probiotics and appropriate drugs combined treatment has a positive effect on T2DM.
Another comprehensive 15 clinical trials use a meta-analysis for the effects of probiotics on HbA1c, FBG, and HOMA-IR (homeostasis model assessment of insulin resistance) in patients with T2DM. The results show that probiotics can reduce HbA1c, FBG, and HOMA-IR values in T2DM. The research results can provide a more comprehensive theoretical basis for the use of probiotics to improve T2DM.
These literature reports show that probiotics have a positive effect on T2DM. However, other clinical trials conducted in the past few years have not been able to support the efficacy of probiotics in the treatment of diabetes. Therefore, although the efficacy of probiotics on T2DM has potential, it still needs to be confirmed by multiple large-scale clinical trials.
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Nestor Cardinali, Carlos Bauman, Facundo Rodriguez Ayala, Roberto Grau. Two cases of type 2 diabetes mellitus successfully treated with Probiotics. Clin Case Rep. 2020;8:3119–3124.
Yun‑Wen Tao, Ying‑Luo Gu, Xin‑Qi Mao, Lei Zhang and Yu‑Fang Pei. Effects of probiotics on type II diabetes mellitus: a meta‑analysis. J Transl Med (2020) 18:30  https://doi.org/10.1186/s12967-020-02213-2