Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis
What this study found
Glucose-lowering drugs generally produced larger reductions in fasting blood glucose and HbA1c than probiotics, with GLP-1 receptor agonists and SGLT-2 inhibitors showing the strongest glycemic effects. Probiotic supplementation still showed beneficial metabolic effects, especially milder improvements in glycemic indices, insulin resistance, and lipid profiles. Probiotics were also associated with reductions in systolic and diastolic blood pressure, and some formulations lowered total cholesterol and triglycerides. Overall, probiotics may be more useful as an adjunct or for less severe type…
- Study & population
- Systematic review and meta-analysis of randomized studies in adults with type 2 diabetes from multiple countries.
- Intervention
- Oral probiotic supplementation was evaluated in multiple formulations, including capsules, sachets, synbiotic food, soy milk, kefir, and fermented milk products.
- Key limitation
- The included evidence had substantial heterogeneity, reflecting different probiotic strains, delivery forms, doses, and short treatment durations of about 6 to 12 weeks.
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Open PDFOriginal abstract
The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP). Moreover, subgroup analyses indicated that participants aged >55 years, BMI ≥30 kg/m2, longer duration of intervention, and subjects from Eastern countries, showed significantly higher reduction in FBS and HbA1c, TC, TG and SBP. This meta-analysis revealed that including multiple probiotic rather than glucose-lowering drugs might be more beneficial regarding T2D prevention who suffering from simultaneously hyperglycemia, hypercholesterolemia, and hypertension.