Type II 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 II diabetes. These patients are at a high risk of cardiovascular disease. Previous research has demonstrated the association of the gut microbiome with metabolic markers and type II diabetes.

This meta-analysis included 32 randomized placebo controlled trials and assessments included body mass index (BMI), total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, c-reactive protein (CRP), HbA1c, fasting glucose, fasting insulin, and blood pressure. These studies included between 20 to 136 patients each over a duration between 4 to 43 weeks. Some studies used a single strain, multi-species, or spores at doses of 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 effect on BMI or LDL cholesterol levels. These results demonstrate that probiotics can improve dyslipidemia and dysglycemia in patients with type II diabetes.

These effects 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 proinflammatory lipopolysaccharides.

Furthermore, the gut microbiome is found to be different in patients with type II diabetes compared to healthy individuals. For example, if one has more Bacteroidetes bacteria, the individual tends to be leaner. High Firmicutes:Bacteroidetes ratios have been known to increase the caloric extraction from food and these individuals tend to be more obese. Also, the ratio of Bacteriodes and Firmicutes has 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 is 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 II diabetes.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Kocsis T, Molnar B, et al. Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials. Sci Rep. 2020 Jul 16;10(1):11787.

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