Vol 10, No 6 (2021)
Research paper
Published online: 2021-05-26

open access

Page views 6344
Article views/downloads 709
Get Citation

Connect on Social Media

Connect on Social Media

Impact of probiotic intake on the glycemic control, lipid profile and inflammatory markers among patients with type 2 diabetes mellitus

Azza Ismail, Olfat Darwish, Dalia Tayel, Dalia Elneily, Gihan Elshaarawy
Clin Diabetol 2021;10(6):468-475.

Abstract

Background. Type 2 diabetes mellitus (T2DM) is

a chronic disease with many dramatic complications.

It has also been suggested that altered intestinal

microbiota leads to increased intestinal permeability

and mucosal immune response, contributing to the

development of diabetes. We aimed to investigate

the effect of introduction of probiotic products on

glycemic control and inflammatory markers among

patients with T2DM.

Methods. The present work was carried on 150 patients

with T2DM. The studied patients were subjected to

full history taking, clinical examination and laboratory

investigations including fasting blood glucose (FBG),

2 hours post prandial blood glucose (2hPP), glycated

hemoglobin (HbA1c), total cholesterol (TC), triglycerides

(TG), HDL-C, LDL-C, C-reactive protein (CRP), interleukin

6 (IL6) and tumor-necrosis factor alpha (TNF a).

They were divided into 3 groups each of 50 patients.

They were all instructed to eat well-balanced diet. The

first group was instructed to eat the well-balanced diet

only, the second group received 2 cups of yogurt daily

in addition to diet and the third group received one

teaspoonful yeast daily in addition to diet. The effect

of the intervention was evaluated after 16 weeks.

Results. Patients receiving yogurt and the patients

receiving yeast showed significant reduction of FBG,

HbA1c, IL6, TNF-a, CRP and significant elevation of HDL-C

compared to patients on diet only. The 3 groups showed

significant reduction in 2hPP blood glucose and LDL-C.

Conclusion. Probiotic intake in patients with T2DM has

beneficial effect on glycemic control, lipid profile and

inflammatory markers after 16 weeks.

Article available in PDF format

View PDF Download PDF file

References

  1. American Diabetes Association. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: . Diabetes Care. 2020; 43(Suppl 1): S48–S65.
  2. Tabish SA. Is Diabetes Becoming the Biggest Epidemic of the Twenty-first Century? Int J Health Sci (Qassim). 2007; 1(2): V–VIII.
  3. Nolan C, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. The Lancet. 2011; 378(9786): 169–181.
  4. Kahn S, Cooper M, Prato SD. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. The Lancet. 2014; 383(9922): 1068–1083.
  5. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011; 11(2): 98–107.
  6. Doi Y, Kiyohara Y, Kubo M, et al. Elevated C-reactive protein is a predictor of the development of diabetes in a general Japanese population: the Hisayama Study. Diabetes Care. 2005; 28(10): 2497–2500.
  7. Marques-Vidal P, Bastardot F, von Känel R, et al. Association between circulating cytokine levels, diabetes and insulin resistance in a population-based sample (CoLaus study). Clin Endocrinol (Oxf). 2013; 78(2): 232–241.
  8. Nadeem A, Naveed AK, Hussain MM, et al. Correlation of inflammatory markers with type 2 Diabetes Mellitus in Pakistani patients. Journal of Postgraduate Medical Institute (Peshawar-Pakistan). 2013; 27(3).
  9. Festa A, D'Agostino R, Tracy RP, et al. Insulin Resistance Atherosclerosis Study. Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes. 2002; 51(4): 1131–1137.
  10. Mirza S, Hossain M, Mathews C, et al. Type 2-diabetes is associated with elevated levels of TNF-alpha, IL-6 and adiponectin and low levels of leptin in a population of Mexican Americans: a cross-sectional study. Cytokine. 2012; 57(1): 136–142.
  11. Varghese A, Asha NS, Celine TM, et al. Inflammatory markers in type II diabetes mellitus. The Pharma Innovation. 2015; 4(7, Part B): 64.
  12. Calle MC, Fernandez ML. Inflammation and type 2 diabetes. Diabetes Metab. 2012; 38(3): 183–191.
  13. Al-Shukaili A, Al-Ghafri S, Al-Marhoobi S, et al. Analysis of inflammatory mediators in type 2 diabetes patients. Int J Endocrinol. 2013; 2013: 976810.
  14. Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care. 2004; 27(3): 813–823.
  15. Rinninella E, Raoul P, Cintoni M, et al. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms. 2019; 7(1).
  16. Rothschild D, Weissbrod O, Barkan E, et al. Environment dominates over host genetics in shaping human gut microbiota. Nature. 2018; 555(7695): 210–215.
  17. Valdes AM, Walter J, Segal E, et al. Role of the gut microbiota in nutrition and health. BMJ. 2018; 361: k2179.
  18. Lu J, Ma K, Ruan X. Dysbiosis of Gut Microbiota Contributes to the Development of Diabetes Mellitus. Infectious Microbes and Diseases. 2019; 1(2): 43–48.
  19. Gurung M, Li Z, You H, et al. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine. 2020; 51: 102590.
  20. Boutagy NE, McMillan RP, Frisard MI, et al. Metabolic endotoxemia with obesity: Is it real and is it relevant? Biochimie. 2016; 124: 11–20.
  21. Cani PD, Possemiers S, Van de Wiele T, et al. Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut. 2009; 58(8): 1091–1103.
  22. Kurtzman CP, Fell JW. Biodiversity and ecophysiology of yeasts. In: Gábor P, de la Rosa CL. ed. The Yeast Handbook. Springer, Berlin 2005: 11–30.
  23. Didari T, Solki S, Mozaffari S, et al. A systematic review of the safety of probiotics. Expert Opin Drug Saf. 2014; 13(2): 227–239.
  24. Czerucka D, Piche T, Rampal P. Yeast as probiotics–Saccharomyces boulardii. Alimentary pharmacology & therapeutics. 2007; 26(6): 767–778.
  25. Smith IM, Baker A, Arneborg N, et al. Non-Saccharomyces yeasts protect against epithelial cell barrier disruption induced by Salmonella enterica subsp. enterica serovar Typhimurium. Lett Appl Microbiol. 2015; 61(5): 491–497.
  26. Saber A, Alipour B, Faghfoori Z, et al. Cellular and molecular effects of yeast probiotics on cancer. Crit Rev Microbiol. 2017; 43(1): 96–115.
  27. 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.
  28. Tabuchi M, Ozaki M, Tamura A, et al. Antidiabetic effect of Lactobacillus GG in streptozotocin-induced diabetic rats. Biosci Biotechnol Biochem. 2003; 67(6): 1421–1424.
  29. Al-Salami H, Butt G, Fawcett JP, et al. Probiotic treatment reduces blood glucose levels and increases systemic absorption of gliclazide in diabetic rats. Eur J Drug Metab Pharmacokinet. 2008; 33(2): 101–106.
  30. Yun SI, Park HO, Kang JH. Effect of Lactobacillus gasseri BNR17 on blood glucose levels and body weight in a mouse model of type 2 diabetes. J Clin Diagn Res. 2009; 107(5): 1681–1686.
  31. Yao K, Zeng L, He Q, et al. Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit. 2017; 23: 3044–3053.
  32. Sun J, Buys NJ. Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials. Br J Nutr. 2016; 115(7): 1167–1177.
  33. Zhang Q, Wu Y, Fei X. Effect of probiotics on glucose metabolism in patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled trials. Medicina (Kaunas). 2016; 52(1): 28–34.
  34. Mifflin MD, St Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr. 1990; 51(2): 241–247.
  35. Li C, Li X, Han H, et al. Effect of probiotics on metabolic profiles in type 2 diabetes mellitus: A meta-analysis of randomized, controlled trials. Medicine (Baltimore). 2016; 95(26): e4088.
  36. Martin AM, Sun EW, Rogers GB, et al. The Influence of the Gut Microbiome on Host Metabolism Through the Regulation of Gut Hormone Release. Front Physiol. 2019; 10: 428.
  37. Gérard C, Vidal H. Impact of gut microbiota on host glycemic control. Front Endocrinol (Lausanne). 2019; 10: 29.
  38. Guo Z, Liu XM, Zhang QX, et al. Influence of consumption of probiotics on the plasma lipid profile: a meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis. 2011; 21(11): 844–850.
  39. Patel AK, Singhania RR, Pandey A, et al. Probiotic bile salt hydrolase: current developments and perspectives. Appl Biochem Biotechnol. 2010; 162(1): 166–180.
  40. Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, et al. Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. J Dairy Sci. 2011; 94(7): 3288–3294.
  41. Hu Ym, Zhou F, Yuan Y, et al. Effects of probiotics supplement in patients with type 2 diabetes mellitus: A meta-analysis of randomized trials. Medicina Clínica (English Edition). 2017; 148(8): 362–370.
  42. Akram Kooshki A, Tofighiyan T, Rakhshani MH. Effects of Synbiotics on Inflammatory Markers in Patients With Type 2 Diabetes Mellitus. Glob J Health Sci. 2015; 7(7 Spec No): 1–5.
  43. Gorbach SL. Probiotics and gastrointestinal health. Am J Gastroenterol. 2000; 95(1 Suppl): S2–S4.
  44. Chiva M, Soriano G, Rochat I, et al. Effect of Lactobacillus johnsonii La1 and antioxidants on intestinal flora and bacterial translocation in rats with experimental cirrhosis. J Hepatol. 2002; 37(4): 456–462.