Endocrine Abstracts

Background: Probiotics have beneficial effect on obesity, insulin resistance and associated metabolic disorders. However, effect of probiotics on β-cell function are inconsistent.

Aim: In a double-blind single center randomized placebo-controlled trials (RCT), effect of alive multistrain probiotic vs. placebo on β-cell function in type 2 diabetes patient were assessed.

Methods: A total of 54 patients met the criteria for inclusion. They were randomly assigned to receive multiprobiotic ‘Symbiter’ (concentrated biomass of 14 probiotic bacteria genera Bifidobacterium, Lactobacillus, Lactococcus, Propionibacterium) or placebo for 8-weeks administered as a sachet formulation in double-blind treatment. The primary main outcome was the assessment of β-cell function as change C-peptide and HOMA-β (homeostasis model assessment-estimated β-cell function) which calculated using HOMA2 calculator (Diabetes Trials Unit, University of Oxford). Secondary outcomes were the changes in glycemic control-related parameters, anthropomorphic variables and cytokines levels. ANCOVA was used to assess the difference between groups.

Results: Supplementation with alive multiprobiotic was associated with slight insignificant improvement of β-cell function (HOMA-β increased from 57.8±4.5 to 65.56±5.96 (P=0.249), insulin sensitivity (S% - 51.75±4.71 to 55.58±4.09; P=0.523) and reduction of insulin resistance (HOMA-2IR −2.44±0.24 to 2.11±0.15; P=0.260) as compared to placebo. With respect to our secondary outcomes, HbA1c significant decreased by 0.45% (P=0.010) only in probiotic responders (patient with increase in HOMA-β) as compared to non-responders was observed.

Conclusion: Probiotic therapies modestly improved β-cell function in patients with type 2 diabetes. Modulation of the gut microbiota represents a new treatment for diabetes and should be tested in larger studies.