Use of Probiotics and Similar in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review

Overview

Journal Rev Paul Pediatr

Specialty Pediatrics

Date 2024 Feb 15

PMID 38359319

Authors

Luisa Pinheiro Neiva

Luiza Correia Lopez

Rafaela Orsi Pasiani

Mayco Jose Reinaldi Serra

Vera Esteves Vagnozzi Rullo

Affiliations

Soon will be listed here.

Abstract

Objective: To perform a systematic review of randomized controlled trials, evaluating the effect of probiotics, prebiotics or symbiotics supplementation on glycemic and inflammatory control in children with Type 1 Diabetes Mellitus (T1DM).

Data Source: The Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Clinical Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO) databases were searched. Randomized clinical trials of pediatric patients with DM1 using probiotics, prebiotics or symbiotics were included, regardless of year or language of publication. Studies that did not evaluate glycated hemoglobin (HbA1c) were excluded. Metabolic results (HbA1c, total insulin dose and C-peptide) and inflammatory control [interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ)] during probiotic supplementation or similar, related to modification of the intestinal microbiota, were analyzed. PROSPERO ID: CRD42022384485.

Data Synthesis: Five studies were selected for a systematic review. Regarding metabolic markers, only one of the articles that analyzed HbA1c showed a significant decrease (p=0.03) in the intervention group. One study identified a reduction in the total dose of insulin and increased C-peptide levels. Regarding the evaluation of inflammatory parameters (IL-10, TNF-α, INF-γ), there were no statistical relevant modifications.

Conclusions: Current data from the literature were not conclusive in identifying an improvement in glycemic control and did not observe changes in inflammatory parameters with the use of probiotics, prebiotics or symbiotics in pediatric patients with T1DM.

Citing Articles

Unravelling the Role of Gut and Oral Microbiota in the Pediatric Population with Type 1 Diabetes Mellitus.

Luppi S, Aldegheri L, Azzalini E, Pacetti E, Barucca Sebastiani G, Fabiani C Int J Mol Sci. 2024; 25(19).

PMID: 39408940 PMC: 11477131. DOI: 10.3390/ijms251910611.

References

Vehik K, Dabelea D . The changing epidemiology of type 1 diabetes: why is it going through the roof?. Diabetes Metab Res Rev. 2011; 27(1):3-13. DOI: 10.1002/dmrr.1141. View

Li X, Atkinson M . The role for gut permeability in the pathogenesis of type 1 diabetes--a solid or leaky concept?. Pediatr Diabetes. 2015; 16(7):485-92. PMC: 4638168. DOI: 10.1111/pedi.12305. View

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

Jones A, Hattersley A . The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med. 2013; 30(7):803-17. PMC: 3748788. DOI: 10.1111/dme.12159. View

Bock P, Telo G, Ramalho R, Sbaraini M, Leivas G, Martins A . The effect of probiotics, prebiotics or synbiotics on metabolic outcomes in individuals with diabetes: a systematic review and meta-analysis. Diabetologia. 2020; 64(1):26-41. DOI: 10.1007/s00125-020-05295-1. View

Hozo S, Djulbegovic B, Hozo I . Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005; 5:13. PMC: 1097734. DOI: 10.1186/1471-2288-5-13. View

Markowiak P, Slizewska K . Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 2017; 9(9). PMC: 5622781. DOI: 10.3390/nu9091021. View

Mishra S, Wang S, Nagpal R, Miller B, Singh R, Taraphder S . Probiotics and Prebiotics for the Amelioration of Type 1 Diabetes: Present and Future Perspectives. Microorganisms. 2019; 7(3). PMC: 6463158. DOI: 10.3390/microorganisms7030067. View

Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N . A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabetes. 2021; 22(7):1014-1022. DOI: 10.1111/pedi.13244. View

10.

Murri M, Leiva I, Gomez-Zumaquero J, Tinahones F, Cardona F, Soriguer F . Gut microbiota in children with type 1 diabetes differs from that in healthy children: a case-control study. BMC Med. 2013; 11:46. PMC: 3621820. DOI: 10.1186/1741-7015-11-46. View

11.

Sapone A, de Magistris L, Pietzak M, Clemente M, Tripathi A, Cucca F . Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes. 2006; 55(5):1443-9. DOI: 10.2337/db05-1593. View

12.

Groele L, Szajewska H, Szalecki M, Swiderska J, Wysocka-Mincewicz M, Ochocinska A . Lack of effect of GG and Bb12 on beta-cell function in children with newly diagnosed type 1 diabetes: a randomised controlled trial. BMJ Open Diabetes Res Care. 2021; 9(1). PMC: 8006832. DOI: 10.1136/bmjdrc-2020-001523. View

13.

Secondulfo M, Iafusco D, Carratu R, Demagistris L, Sapone A, Generoso M . Ultrastructural mucosal alterations and increased intestinal permeability in non-celiac, type I diabetic patients. Dig Liver Dis. 2004; 36(1):35-45. DOI: 10.1016/j.dld.2003.09.016. View

14.

Kostic A, Gevers D, Siljander H, Vatanen T, Hyotylainen T, Hamalainen A . The dynamics of the human infant gut microbiome in development and in progression toward type 1 diabetes. Cell Host Microbe. 2015; 17(2):260-73. PMC: 4689191. DOI: 10.1016/j.chom.2015.01.001. View

15.

Homayouni-Rad A, Soroush A, Khalili L, Norouzi-Panahi L, Kasaie Z, Ejtahed H . Diabetes Management by Probiotics: Current Knowledge and Future Pespective. Int J Vitam Nutr Res. 2017; 86(3-4):215-227. DOI: 10.1024/0300-9831/a000273. View

16.

Leiva-Gea I, Sanchez-Alcoholado L, Martin-Tejedor B, Castellano-Castillo D, Moreno-Indias I, Urda-Cardona A . Gut Microbiota Differs in Composition and Functionality Between Children With Type 1 Diabetes and MODY2 and Healthy Control Subjects: A Case-Control Study. Diabetes Care. 2018; 41(11):2385-2395. DOI: 10.2337/dc18-0253. View

17.

Bengmark S . Bioecologic control of the gastrointestinal tract: the role of flora and supplemented probiotics and synbiotics. Gastroenterol Clin North Am. 2005; 34(3):413-36, viii. DOI: 10.1016/j.gtc.2005.05.002. View

18.

Wang C, Yen H, Lu W, Ho H, Lin W, Kuo Y . Adjuvant Probiotics of subsp. AP-32, MH-68, and subsp. CP-9 Attenuate Glycemic Levels and Inflammatory Cytokines in Patients With Type 1 Diabetes Mellitus. Front Endocrinol (Lausanne). 2022; 13:754401. PMC: 8921459. DOI: 10.3389/fendo.2022.754401. View

19.

Primavera M, Giannini C, Chiarelli F . Prediction and Prevention of Type 1 Diabetes. Front Endocrinol (Lausanne). 2020; 11:248. PMC: 7326081. DOI: 10.3389/fendo.2020.00248. View

20.

Javid A, Aminzadeh M, Haghighi-Zadeh M, Jamalvandi M . The Effects of Synbiotic Supplementation on Glycemic Status, Lipid Profile, and Biomarkers of Oxidative Stress in Type 1 Diabetic Patients. A Placebo-Controlled, Double-Blind, Randomized Clinical Trial. Diabetes Metab Syndr Obes. 2020; 13:607-617. PMC: 7060036. DOI: 10.2147/DMSO.S238867. View