Multispecies Probiotics and Diabetes

by | Sep 6, 2016 | 2013, Diabetes, Probiotics

Written by Joyce Smith, BS. Diabetic patients who took a multispecies probiotic for 8 weeks had significant improvements in fasting blood glucose, insulin resistance, C-reactive protein, and total glutathione compared to control.       .

Type 2 diabetes is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and/or insulin insufficiency. 1 Almost 8% of the Iranian adult population 2 and around 258 million people worldwide suffered from diabetes in 2010. 3 In the year 2014, diabetes in the United States (U.S.) in our 20 years and older population was 28.9 million or 12.3 % of the population. 2.1 million more American men than women were diabetic. In our 65 years and older population, 11.2 million (25.9%) were diabetic. 4 When cells of the pancreas are unable to secrete enough insulin to overcome insulin resistance, blood glucose levels rise above the normal range. Insulin resistance is a condition in which the cells of the body become resistant to the hormone insulin. Insulin resistance has been associated with a higher risk of developing heart disease and precedes the development of type 2 diabetes (T2D). 1

Besides the diet and glucose-lowering medication, various strategies have been used to control diabetes 5 such as  antioxidants, vitamins E, A, and C, and coenzyme Q 10,6 Agents that lower oxidative stress 7 and anti-inflammatory agents such as low-dose aspirin and statins 8 are also used.

Other studies have shown that probiotics can reduce the risk of heart attack and stroke by reducing inflammation, 9 stress, 10 cholesterol levels, 11 and hypertension. They do this by improving insulin sensitivity, 12 increasing glutathione levels, 13 scavenging free radicals, 13 helping with weight loss, 14 and improving glucose metabolism. Two probiotics, in particular, Lactobacillus acidophilus and L. casei, help regulate blood glucose levels and improve insulin resistance, which may potentially lead to a reduced risk of cardiovascular events. 12

Past studies have focused on animal models and non-diabetic individuals, thus researchers chose to explore the effects of a multispecies probiotic supplement on hs-CRP and oxidative stress in type 2 diabetic patients (T2D). The C-reactive protein (CRP) increases with increased inflammation in the body. High sensitive C-reactive protein (Hs-CRP) is more sensitive than the regular C-reactive protein and is often performed to assess the risk of future heart disease.

This study is a double-blinded, controlled clinical trial of 54 diabetic patients aged 35-70 years, who were randomly selected to receive 8 weeks of supplementation with either a multispecies probiotic supplement (n=27) or a placebo (n=27). The probiotic supplement contained the following 7 viable and freeze-dried strains: Lactobacillus acidophilus (2 × 109 CFU), L. casei (7 × 109 CFU), L. rhamnosus (1.5 × 109 CFU), L. bulgaricus (2 × 108 CFU), Bifidobacterium breve (2 × 1010 CFU), B. longum (7 × 109 CFU), Streptococcus thermophilus (1.5 × 109 CFU). The placebo consisted of 100 mg of fructo-oligosaccharide.

All patients were instructed to avoid probiotic foods and to chart their food intake for 2 weeks prior to the study. During the 8-week probiotic supplementation, patients were forbidden to take probiotics or eat fermented foods. They also maintained 3- day dietary records throughout the study period. Fasting blood samples were taken at baseline and after 8 weeks of treatment to measure metabolic profiles, hs-CRP, and biomarkers of oxidative stress including plasma total antioxidant capacity and total glutathione (GSH). Student’s t test was used to detect differences between the placebo and probiotic supplement groups. This test can determine if two sets of data are significantly different from each other. P < 0.05 was considered statistically significant.

Researchers observed the following results:

  • When comparing the fasting plasma glucose (FPG) of probiotic and control groups, researchers found that taking probiotic supplements prevented a rise in FPG (+28.8 ± 8.5 for placebo vs. +1.6 ± 6 mg/dl for the probiotic group, p = 0.01).
  • Serum insulin and low-density lipoprotein cholesterol levels had significant but similar increases in both groups.
  • Significant increases also occurred in HOMA-IR (homeostasis model of assessment-insulin resistance) in both the probiotic group (p = 0.02) and the placebo group (p = 0.001); however, the increase in the placebo group was significantly higher than that in the probiotic group (+2.38 vs. +0.78, p = 0.03).
  • Mean changes in serum hs-CRP were significantly different between the two groups (-777.57 for the probiotic group vs. +878.72 ng/ml for the placebo group, p = 0.02).
  • Plasma GSH level increased significantly in the probiotic group compared to placebo. (240.63 vs. -33.46 µmol/l, p = 0.03).
Metabolic
Profiles
Probiotic GroupControl GroupP value
FPG+1.6 ± 6 mg/dl+28.8 ± 8.5 mg/dlP=0.01
CRP-777.57 ng/ml+878.72 ng/mlP=0.02
GSH+240.63 µmol/l-33.46 µmol/lP=0.03

The authors concluded that diabetic patients who took a multispecies probiotic supplementation for 8 weeks had significantly decreased hs-CRP and significantly increased plasma total GSH compared with placebo. Both probiotic and placebo groups had significantly increased serum insulin levels and HOMA-IR; however, these effects were lower in diabetic patients receiving probiotics compared to the placebo group.

Although these results showed that supplementing with multispecies probiotics prevented the rise of FPG, they showed no benefit on the rest of glycemic control of diabetic patients.

The authors note that these study results differ when compared with other studies. They believe these inconsistencies could be due to differences in the conditions of the studied populations and the discrepancy in probiotic species, strains and dosages.

Source: Asemi, Zatollah, Zohreh Zare, Hossein Shakeri, Sima-sadat Sabihi, and Ahmad Esmaillzadeh. “Effect of multispecies probiotic supplements on metabolic profiles, hs-CRP, and oxidative stress in patients with type 2 diabetes.” Annals of Nutrition and Metabolism 63, no. 1-2 (2013): 1-9.

© 2013 S. Karger AG, Basel

Posted September 6, 2016.

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