Allam Abdallah R, Helal Mohamed Basyouni, Alhateem Mohamed Salah, Shehab Mohamed Ashraf, Elshaar Ahmed Gamal, Saeda Mohamed Ahmed, Ibrahim Fatma Magdi, Khalil Ahmed Maher, Mahmoud Abdelrahman Mohamed
Faculty of Medicine, Menoufia University, Yassin Abdelghaffar Street From Gamal Abdelnaser Street, Shebin Al-Kom, 32511, Menoufia, Egypt.
RAK Medical and Health Sciences University, RAK College of Nursing, RAS-Al Khaimah, UAE.
Diabetol Metab Syndr. 2025 Jul 11;17(1):265. doi: 10.1186/s13098-025-01841-2.
Type 2 diabetes mellitus (T2DM) is a global health concern with a rising prevalence. Recent studies indicate that the gut microbiota plays a role in the development of T2DM, making probiotics a promising avenue for proper glycemic control. This network meta-analysis aims to comprehensively assess various probiotic therapies in the management of T2DM.
All published randomized controlled trials (RCTs) were identified through searches in PubMed, Cochrane, and Web of Science. Included RCTs were evaluated using the Cochrane risk of bias tool 2. The retrieved data were pooled, where the mean difference (MD) and a 95% confidence interval (CI) were calculated using the R program version 4.2.1.
A total of 62 RCTs were included, with baseline hemoglobin A1c (HbA1c) ranging from 5.71% to 9.5%. Among all interventions, the combination of Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19, and Lactococcus lactis W58 achieved the greatest reduction in fasting plasma glucose (FPG) [MD = - 73.50; 95% CI: - 113.13 to - 33.86]. The greatest reduction in HbA1c was observed with yogurt containing Lactobacillus acidophilus La5, Bifidobacterium Bb12, and Cucurbita ficifolia [MD = - 1.59; 95% CI: - 3.07 to - 0.12]. For total cholesterol, the top-performing intervention was yeast containing Saccharomyces cerevisiae [MD = - 43.67; 95% CI: - 57.07 to - 30.27].
Our network meta-analysis suggests that specific probiotic formulations, including combinations of various strains of Lactobacillus, Bifidobacterium, yogurt-based formulations containing Lactobacillus acidophilus La5, Bifidobacterium Bb12 with Cucurbita ficifolia, and Saccharomyces cerevisiae yeast, may be beneficial as adjunctive therapies for improving glycemic control and lipid profiles in patients with T2DM. However, these findings should be interpreted with caution due to variability in study designs, probiotic regimens, and potential risk of bias.
2型糖尿病（T2DM）是一个全球性的健康问题，其患病率呈上升趋势。最近的研究表明，肠道微生物群在T2DM的发生发展中起作用，这使得益生菌成为实现血糖合理控制的一个有前景的途径。这项网状Meta分析旨在全面评估各种益生菌疗法在T2DM管理中的作用。
通过在PubMed、Cochrane和Web of Science中检索，确定所有已发表的随机对照试验（RCT）。使用Cochrane偏倚风险工具2对纳入的RCT进行评估。对检索到的数据进行汇总，使用R程序版本4.2.1计算平均差（MD）和95%置信区间（CI）。
共纳入62项RCT，基线糖化血红蛋白（HbA1c）范围为5.71%至9.5%。在所有干预措施中，两歧双歧杆菌W23、乳酸双歧杆菌W52、嗜酸乳杆菌W37、短乳杆菌W63、干酪乳杆菌W56、唾液乳杆菌W24、乳酸乳球菌W19和乳酸乳球菌W58的组合使空腹血糖（FPG）降低幅度最大[MD = - 73.50；95% CI：- 113.13至 - 33.8]。含嗜酸乳杆菌La5、双歧杆菌Bb12和番木瓜的酸奶使HbA1c降低幅度最大[MD = - 1.59；95% CI：- 3.07至 - 0.12]。对于总胆固醇，表现最佳的干预措施是含酿酒酵母的酵母制剂[MD = - 43.6；95% CI：- 57.07至×30.27]。
我们的网状Meta分析表明，特定的益生菌制剂，包括各种乳酸杆菌、双歧杆菌菌株的组合，含嗜酸乳杆菌La5、双歧杆菌Bb12和番木瓜的酸奶制剂，以及酿酒酵母酵母制剂，作为辅助疗法可能有助于改善T2DM患者的血糖控制和血脂水平。然而，由于研究设计、益生菌方案的变异性以及潜在的偏倚风险，这些发现应谨慎解读。
