Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Nutrients. 2024 Aug 9;16(16):2629. doi: 10.3390/nu16162629.
Human recombinant insulin is currently the only therapy for children and adolescents with type 1 diabetes (T1D), although not always efficient for the glycemic control of these individuals. The interrelation between the gut microbiome and the glycemic control of apparently healthy populations, as well as various populations with diabetes, is undeniable. Probiotics are biotherapeutics that deliver active components to various targets, primarily the gastrointestinal tract. This systematic review and meta-analysis examined the effect of the administration of probiotics on the glycemic control of pediatric and adolescent individuals with T1D.
Randomized controlled trials employing the administration of probiotics in children and adolescents with T1D (with ≥10 individuals per treatment arm), written in English, providing parameters of glycemic control, such as mean glucose concentrations and glycosylated hemoglobin (HbA1c), were deemed eligible.
The search strategy resulted in six papers with contradictory findings. Ultimately, five studies of acceptable quality, comprising 388 children and adolescents with T1D, were included in the meta-analysis. Employing a random and fixed effects model revealed statistically significant negative effect sizes of probiotics on the glycemic control of those individuals, i.e., higher concentrations of glucose and HbA1c than controls.
Children and adolescents with T1D who received probiotics demonstrated worse glycemic control than controls after the intervention. Adequately powered studies, with extended follow-up periods, along with monitoring of compliance and employing the proper strains, are required to unravel the mechanisms of action and the relative effects of probiotics, particularly concerning diabetes-related complications and metabolic outcomes.
人重组胰岛素目前是 1 型糖尿病（T1D）儿童和青少年的唯一治疗方法，但对于这些个体的血糖控制并不总是有效。肠道微生物组与明显健康人群以及各种糖尿病人群的血糖控制之间的相互关系是不可否认的。益生菌是一种生物治疗剂，可将活性成分输送到各种靶标，主要是胃肠道。本系统评价和荟萃分析检查了益生菌给药对 T1D 儿科和青少年个体血糖控制的影响。
采用益生菌给药治疗 T1D 儿童和青少年（每个治疗组至少 10 人）的随机对照试验，用英语书写，并提供血糖控制参数，如平均血糖浓度和糖化血红蛋白（HbA1c），被认为符合条件。
搜索策略产生了 6 篇具有相反发现的论文。最终，纳入了 5 项质量可接受的研究，共纳入 388 名 T1D 儿童和青少年。采用随机和固定效应模型发现，益生菌对这些个体血糖控制的负效应大小具有统计学意义，即葡萄糖和 HbA1c 浓度高于对照组。
接受益生菌治疗的 T1D 儿童和青少年在干预后血糖控制比对照组差。需要进行足够大的、随访时间延长的研究，同时监测依从性并使用适当的菌株，以揭示益生菌的作用机制和相对效果，特别是在糖尿病相关并发症和代谢结果方面。
