Effects of probiotic supplementation on intestinal microbiota in patients with diabetes/prediabetes: a systematic review and meta-analysis of randomized controlled trials.

Probiotic supplementation significantly increased fecal Lactobacillus levels in patients with diabetes/prediabetes.

• Standardized mean difference (SMD) of 1.42 for fecal Lactobacillus levels
• P < 0.0001, I2 = 95%
• 12 RCTs involving 1113 participants were included
• High heterogeneity was observed across studies (I2 = 95%)

Probiotic supplementation significantly increased fecal Bifidobacterium levels in patients with diabetes/prediabetes.

• Standardized mean difference (SMD) of 1.27 for fecal Bifidobacterium levels
• P < 0.0001, I2 = 90%
• High heterogeneity was observed across studies (I2 = 90%)
• Probiotics were administered as adjunctive therapy alongside standard care

Probiotic supplementation significantly reduced fasting plasma glucose (FPG) in patients with diabetes/prediabetes.

• Standardized mean difference (SMD) of -0.35 for fasting plasma glucose
• P = 0.004
• The intervention group received probiotics alongside standard care while the control group received standard care alone
• 12 RCTs involving 1113 participants contributed to this analysis

Shorter intervention durations (≤ 3 months) were associated with improvements in FPG, HbA1c, and Bifidobacterium levels.

• Subgroup analysis by intervention duration showed that ≤ 3 months of probiotic supplementation improved FPG, HbA1c, and Bifidobacterium levels
• Intervention duration was identified as a key factor influencing treatment effectiveness
• The analyses were conducted using Revman 5.3 and Stata 16

Younger patients (≤ 60 years) experienced the most significant improvements in Bifidobacterium levels following probiotic supplementation.

• Subgroup analysis by patient age showed that patients ≤ 60 years experienced the most significant improvements in Bifidobacterium levels
• Patient age was identified as a key factor influencing treatment effectiveness alongside intervention duration
• The study emphasizes precision treatment by identifying optimal target populations and conditions for effective probiotic use

The systematic review and meta-analysis included 12 RCTs involving 1113 participants identified through a comprehensive multi-database search.

• Databases searched included PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Internet (CNKI), and Wanfang databases
• Search was conducted until April 2024
• Data were managed with Endnote and Excel
• Only randomized controlled trials assessing probiotics as adjunctive therapy for diabetes were included