Science Update

Recent Meta-analysis Investigates Relationship Between Probiotics and Prediabetes

Prediabetes is a state involving elevated blood sugar levels and impaired glucose regulation that does not meet the criteria for diabetes. Research indicates that approximately 70% of individuals with prediabetes may develop diabetes. Certain lifestyle changes and micronutrients have been shown to potentially help delay the progression to diabetes. Recent research indicates that probiotics may help support certain parameters related to blood sugar metabolism.  

Certain probiotic strains have been shown in studies to help decrease levels of certain proinflammatory cytokines. They also may help reduce the abundance of microbiota related to the inflammatory response and insulin resistance. It is thought that probiotics may help promote glucagon-like peptide-1 (GLP-1) secretion from intestinal L cells. Short-chain fatty acids (SCFAs) produced by certain agents in the gut microbiome may also help support GLP-1 production. Probiotics such as Lactobacillus casei have been shown to help influence the function of pancreatic β-cells in individuals with prediabetes. 

While the biochemical mechanisms are not yet fully understood, research indicates that some probiotics may help support blood sugar homeostasis and help modulate certain aspects of insulin resistance. A recently published meta-analysis and systematic review by Li and colleagues explored the potential efficacy of probiotic supplementation on biomarkers related to prediabetes. The study included seven research trials involving 460 patients. 

Li and colleagues reported that supplementation with probiotics helped improve several parameters when compared with placebo. Study results indicate that probiotic supplementation helped promote the proliferation of certain microbiota that have been shown to help support health such as Lactobacillus. They also helped reduce bacteria associated with insulin resistance including Barnesiella spp and Butyrivibrio crossotus. Probiotic intake was also shown to help reduce populations of Firmicutes, which is associated with the inflammatory response and insulin resistance. Probiotic supplementation has also been shown to help increase SCFA-producing microbiota. 

Significant improvements in hemoglobin A1c (HbA1c) and quantitative insulin check index (QUICKI) were reported in the study by Li and colleagues. However, no statistically significant improvements in fasting blood glucose, high-density lipoprotein-C, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels were reported in this study.

The authors report that probiotics may also help support certain aspects of lipid metabolism. Results from the systematic review and meta-analysis indicate significant improvements in total cholesterol, triglycerides, and low-density lipoprotein-C in the presence of probiotic supplementation. 

Probiotics help support many aspects of human health. They may help promote gastrointestinal health, cognitive function, and immune health. Recent research indicates they may also help support certain parameters related to lipid and blood sugar metabolism.

By Colleen Ambrose, ND, MAT