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Probiotic Therapy May Show Benefits in Type 2 Diabetes

Sep 29, 2018

Probiotics for diabetes? Recent study shows improvements in insulin resistance and endotoxin-induced inflammation after taking probiotic supplementation, compared to placebo.

In recent years, there has been an increased interest in understanding the role of human microbiome in diseases and what factors may be influenced with the use of prebiotics and probiotics. Scientists predict the emerging industry to be worth over $64 billion by 2022. Regardless of this interest, there is limited understanding into the use of prebiotics and probiotics for the management of type 2 diabetes.

Shaun Sabico, MD, PhD, Saudi Arabia, mentioned in an interview that, “People with diabetes have altered gut microbiota….Manipulation of the gut microbiome through multi-strain probiotic supplementation can improve insulin sensitivity.”

Dr. Sabico and colleagues conducted a single-center, double-blind, randomized, placebo-controlled study that analyzed data from 61 adults (35 women) with a recent diagnosis of type 2 diabetes. Participants were ages 30 to 60 years and were recruited between January 2014 and February 2016 from the outpatient department of King Salman Hospital in Riyadh. The subjects were randomly assigned 2 gram sachets of freeze-dried probiotic powder, which included eight probiotic strains (n = 31; mean age, 48 years; mean BMI, 29.4 kg/m2), or placebo sachets containing 2 grams of freeze-dried maize starch and maltodextrins (n = 30; mean age, 47 years; mean BMI, 30.1 kg/m2) twice daily before breakfast and bedtime for 6 months. Height, weight, blood pressure, waist and hip measurements, BMI and waist-to-hip ratio were calculated at baseline, 3 months and 6 months, as well as glucose levels and lipid profiles. Insulin resistance was also measured.

Circulating endotoxin levels were the primary outcome of the study and glycemic parameters, lipid profile, inflammatory, and adipocytokine markers were the secondary outcomes.

At 3 months and 6 months, the probiotic group was favored after researchers observed percent change differences in HOMA-IR  (3 months 0% vs. -60.4%; 6 months 20.5% vs. 64.2%). Within group comparisons, all inflammatory markers showed improvement over time in the probiotic group. No between-group differences were seen for lipid markers, although improvements in triglycerides, total cholesterol, and HDL cholesterol were seen in the probiotics group.

For within-group comparisons, an average decrease (-58.1%) in resistin levels from baseline to 6 months was observed in the probiotic group (P < 0.05) and an average increase (38.1%) in endotoxin levels at 6 months vs. 3 months in the placebo group. In the group taking probiotics, endotoxin levels were improved (average decrease at 6 months -69%) and adiponectin levels (average increase at 6 months, 71.8%).

“Our study is, to our knowledge, the first to demonstrate the effects of a multi-strain probiotic supplement given over 6 months in the Arab [type 2 diabetes] population, using endotoxin as the primary endpoint,” the researchers wrote. “It is also important to stress that the probiotic supplementation in this present study was used as a standalone treatment given in the absence of exercise and diet-related modifications in the intervention or lifestyle control in a culture with easy access to food.”

Researchers added that the sample size used in this study was small and the participants who were in the probiotics group were less metabolically healthy when compared to the placebo group.

“Multi-strain probiotic supplementation can be beneficial for the prevention of diabetes and as an adjuvant therapy for people with diabetes thereby reducing healthcare costs,” Dr. Sabico states.

Practice Pearls:

  • 61 participants recently diagnosed with T2D were included in the study and assigned either 2 grams of probiotic powder or placebo twice daily for 6 months.
  • Participants taking probiotics showed an improvement in insulin resistance, as well as endotoxin and inflammatory adipokine levels.
  • Multi-strain probiotic supplementation can be beneficial for the prevention of diabetes and as an adjuvant therapy for people with diabetes thereby reducing healthcare costs.


Sabico S, et al. “Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: A randomized, double-blind, placebo-controlled trial.” Clin Nutr 2018; doi:10.1016/j.clnu.2018.08.009.

Melissa Bailey, Pharm.D. Candidate, USF College of Pharmacy


For more information on supplements like probiotics for diabetes, visit our Diet and Nutrition therapy center.