Probiotic supplementation in diabetic hemodialysis patients has beneficial metabolic effects.

This 12-week interventional study enrolled adults with diabetes receiving regular hemodialysis at Akhavan Clinic in Kashan, Iran. The probiotic arm included 30 participants, with dietary intake and physical activity monitored during the trial.

Participants in the probiotic arm took one oral capsule daily for 12 weeks containing Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum (2 × 10^9 CFU/g each). The product was manufactured by Tak Gen Zist Pharmaceutical Company in Tehran, Iran.

Twelve weeks of probiotic supplementation was associated with better glycemic control and favorable changes in some inflammatory and oxidative stress markers, while lipid profiles were not markedly affected. In the probiotic group, fasting plasma glucose fell from 126.3 to 104.3 (change −22.0), insulin from 21.6 to 15.2 (change −6.4), HOMA-IR from 6.9 to 4.0 (change −2.9), QUICKI rose from 0.29 to 0.32 (change 0.03), and HbA1c fell from 5.9 to 5.5 (change −0.4). hs-CRP declined from 8043.3 to 6110.0 (change −1933.3) and MDA from 2.4 to 2.1 (change −0.3), whereas triglycerides, total cholesterol, LDL, and HDL changed little. No significant adverse events or gastrointestinal symptoms were reported.

Interpretation is limited by the modest sample size in the probiotic arm (n=30), the short 12-week follow-up, and the single-center setting in Kashan, Iran. The evidence is based mainly on surrogate biochemical endpoints, and the packet does not provide full comparative effect estimates for every outcome.