College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.
Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Diabetes Res Clin Pract. 2023 Aug;202:110806. doi: 10.1016/j.diabres.2023.110806. Epub 2023 Jun 25.
Lifestyle changes and dietary intervention, including the use of probiotics, can modulate dysbiosis of gut microbiome and contribute to the management of type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aim to assess the efficacy of metformin plus probiotics versus metformin alone on outcomes in patients with T2DM.
We searched MEDLINE and EMBASE from inception to February 2023 to identify all randomized controlled trials (RCTs), which compared the use of metformin plus probiotics versus metformin alone in adult patients with T2DM. Data were summarized as mean differences (MD) with 95 % confidence interval (CI) and pooled under the random effects model.
Fourteen RCTs (17 comparisons, 1009 patients) were included in this systematic review. Pooled results show a significant decrease in fasting glucose (FG) (MD = -0.64, 95 % CI = -1.06, -0.22) and HbA1c (MD = -0.29, 95 % CI = -0.47, -0.10) levels in patients with T2DM treated with metformin plus probiotics versus metformin alone. The addition of probiotics to metformin resulted in lower odds of gastrointestinal adverse events (Odds ratio = 0.18, 95 % CI = 0.09, 0.3.8; I = 0 %).
The addition of probiotics to metformin therapy is associated with improvement in T2DM outcomes. However, high-quality and adequately reported RCTs are needed in the future to confirm our findings.
生活方式的改变和饮食干预，包括使用益生菌，可以调节肠道微生物组的失调，并有助于 2 型糖尿病（T2DM）的管理。本系统评价和荟萃分析旨在评估二甲双胍联合益生菌与单独使用二甲双胍在 T2DM 患者中的疗效。
我们从建库到 2023 年 2 月在 MEDLINE 和 EMBASE 中搜索了所有比较二甲双胍联合益生菌与单独使用二甲双胍治疗 T2DM 成年患者的随机对照试验（RCT）。数据以均数差（MD）和 95%置信区间（CI）表示，并采用随机效应模型进行汇总。
本系统评价纳入了 14 项 RCT（17 项比较，1009 名患者）。汇总结果显示，与单独使用二甲双胍相比，T2DM 患者使用二甲双胍联合益生菌治疗后空腹血糖（FG）（MD=-0.64，95%CI=-1.06，-0.22）和糖化血红蛋白（HbA1c）（MD=-0.29，95%CI=-0.47，-0.10）水平显著降低。与单独使用二甲双胍相比，联合使用益生菌可降低胃肠道不良事件的发生几率（优势比=0.18，95%CI=0.09，0.38；I=0%）。
在二甲双胍治疗中添加益生菌可改善 T2DM 的结局。然而，未来仍需要高质量和充分报告的 RCT 来证实我们的发现。
