Effectiveness of probiotics in type 2 diabetes: A meta-analysis

Pol Arch Med Wewn. 2015;125(11):803–12

Since ancient days, probiotics are known to be helpful in maintaining the optimal health and functioning of the gut by balancing intestinal microbiota. However, in the recent past it has been found that products containing such ‘friendly’ and ‘healthful’ bacteria are also effective in preventing and/or treating a wide range of health conditions, including irritable bowel syndrome/disease, chronic idiopathic constipation, diarrhea, obesity, allergic and pulmonary diseases, and various types of inflammatory conditions.

There are some reports claiming that that probiotic supplementation alone or foods supplemented with probiotics may positively influence hyperglycemia and associated metabolic disturbances, directly or indirectly.


To assess the effect of probiotic supplementation on selected modifiable cardio-metabolic risk factors in type II diabetes.

Study Design
  • In this meta-analysis of existing research, data extraction and selection criteria was based on PRISMA guidelines
  • The PubMed, Embase, Cochrane Library, and Scopus databases were searched using the keywords “probiotics” and “diabetes”, and only full-text articles published in English, which were last updated in January 2015
  • Only randomized controlled trials (RCTs) assessing type 2 diabetes in the original study were included in the meta-analysis
  • Studies covering specified probiotic, probiotic mixes, synbiotics, or dairy products containing probiotic bacteria as therapeutic interventions, compared with placebo were considered
  • Parameters like fasting plasma glucose (FPG), insulin concentration, insulin resistance estimated using the homeostatic model assessment (HOMA-IR), haemoglobin A1c (HbA1c), and the levels of total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and C-reactive protein (CRP) were the outcomes of interest
Results and Discussion
  • The met-analysis included a total of 8 RCTs with 438 subjects, which met the inclusion criteria
  • Probiotics consumption significantly reduced HbA1c and HOMA-IR (for insulin resistance) when compared placebo groups
  • A significant decrease in the levels of TC, TG, LDL-C and CRP was observed, whereas HDL-C level was found to be increased in some RCTs after the administration of probiotics

In conclusion, this meta-analysis suggested that supplementation with probiotic might be beneficial in improving selected cardiometabolic parameters in type 2 diabetic patients. Larger well-designed, randomized studies are advocated before recommended for use as supportive therapy of type 2 diabetes.

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Efficacy of a synbiotic chewable tablet in the prevention of antibiotic-associated diarrhea

Health. 2011;3(2):110–15

Although use of antibiotics has been helpful in decreasing mortality and improved the success rates of surgical procedures, chronic treatment with broad-spectrum antibiotics has led to a significant increase in the incidence of antibiotic-associated diarrhea (ADD), especially in chronically ill elderly patients.

Infection by Clostridium difficile, a bacterial, spore-forming, anaerobic species, is the leading cause of AAD in 25–50% of individuals on chronic antibiotic treatment. Every year, estimated 15,000–30,000 deaths are occurring in the US due to C. difficile infections.

Use of probiotics as a supplemental and alternate method in the treatment and prevention of C. difficile infection is gaining importance, as probiotics are known to support growth of beneficial microbes, which are lost from the digestive tract during antibiotic treatment.


To examine the efficacy of using probiotics with regard to ADD and C. difficile infection in patients undergoing antibiotic therapy.

Study Design
  • Presence of AAD and C. difficile infection was evaluated retrospectively in 120 nursing home residents (female=77; male=43) at the beginning of the antibiotic treatment
  • Residents were provided with symbiotic tablet (twice daily) containing two probiotics [yeast Saccharomyces boulardii (7.5 billion CFU) and bacteria B. coagulans (1 billion CFU)] and a probiotic [fructo-oligosaccharide (500 mg)] shortly after the initiation of antibiotic treatment
  • Administration of the synbiotic tablet continued for two weeks after antibiotic treatment was completed followed by evaluation for the presence of AAD and C. difficile infection
  • In addition, all adverse events, side effects, resident compliance, and ease of administration with regard to taking the synbiotic tablet were noted. All data were obtained from resident records
Results and Discussion
  • Sixty four residents out of 120 began taking the synbiotic tablet immediately after beginning antibiotic treatment (i.e. at day 0)
  • Two weeks post antibiotic therapy; residents were evaluated for the presence of AAD and C. difficile infection 2 weeks, during which they were advised to continue to take synbiotic tablets
  • Results showed that 95% of the residents (n=114) remained free of AAD, while >98% of the study population was devoid of C. difficile infection (n=118)
  • Clinicians found that compliance as well as ease of administration of the synbiotic tablet was very high (93% and 97%, respectively)
  • During the study, no adverse reactions or minor side effects were reported in any of the residents taking symbiotic tablet

It was concluded that use of synbiotic tablet was an effective and safe approach in controlling ADD and C. difficile infection in patient population on chronic antibiotic therapy.

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Prevention of antibiotic-associated diarrhea with Lactobacillus sporogens and fructo-oligosaccharides in children. A multicentric double-blind vs placebo study

Minerva Pediatr. 2003;55(5):447–52

One of the common complications associated with antibiotics treatment is diarrhea. Antibiotic-associated diarrhea (AAD) is an unexplained diarrhea, wherein colonic microbiota gets disrupted. Incidence of ADD as high as 30% might be seen in some instances, based on the type of antibiotic used and the population.

Though this side effect is generally seen among the elderly ailing patients, children (especially <2 years old) are also at high risk to encounter ADD. Hence, several approaches have been adapted to prevent its occurrence, including use of probiotics.

Several studies have claimed the beneficial effects of probiotics in children suffering from antibiotic-associated diarrhea.


To determine the efficacy of a fructo-oligosaccharides (FOS) and Bacillus coagulans (earlier known as Lactobacillus sporogens) preparation in the prevention of antibiotic-induced diarrhea in children.

Study Design
  • In this multicentre, randomized, double-blind study, 120 children with active infections needing antibiotics treatment were treated with preparation containing FOS and B. coagulans combination for 10 days
  • Results were obtained based on the records from patients’ diary as well as from follow-up examinations at the clinic
Results and Discussion
  • Out of 120 children, 98 were eligible for the outcome evaluation
  • Results suggested that treatment group had lesser incidence of diarrhea compared to placebo (i.e. 29% vs. 62%)
  • In addition, compared to control, the duration of diarrhea was less in the active group (0.7 vs. 1.6 days; p=0.002)

It was concluded that prophylactic use of FOS-B. coagulans preparation provided significant benefits in children with antibiotic-induced diarrhea.

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Short term hypolipidemic effects of oral lactobacillus sporogenes therapy in patients with primary dyslipidemias

Indian Heart J. 1990;42(5):361–64.

Dyslipidemia is a disorder of lipoprotein metabolism, which includes lipoprotein overproduction or deficiency. Elevated serum total cholesterol, low-density lipoprotein (LDL) cholesterol and triglyceride levels, and low level of high-density lipoprotein (HDL) cholesterol is evident in this condition.

Traditionally, dyslipidemias were classified based on the patterns of elevation in lipids and lipoproteins. However, categorizing them as primary or secondary dyslipidemias (based on different characteristics) is a more practical approach.

Several study reports have suggested that consumption of probiotics may be used as an alternative approach in the management and/or treatment of dyslipidemia condition.


To evaluate short-term hyolipidemic effects of oral Bacillus coagulans (earlier known as Lactobacillus sporogens) therapy.

Study Design

In this open-label, fixed-dose clinical trial, 17 patients (male=15; female=2) diagnosed with type II hyperlipidemia were given Bacillus coagulans (earlier known as Lactobacillus sporogens) (360 million spores per day) for 3 months.

Results and Discussion
  • Compared to baseline, a significant reduction in total cholesterol (226±46 mg% vs. 330±55 mg%, p<0.001) and LDL-cholesterol (173±54 mg% vs. 267±58 mg%, p<0.001) was observed
  • Level of HDL-cholesterol was marginally increased (46.8±8.9 mg% vs. 43.6±7 mg%, p<0.05) with no change in serum triglyceride concentration
  • There were no adverse effects reported

Treating dyslipidemias with oral Bacillus coagulans therapy could be an effective alternative after confirmation in larger trials.

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