糖尿病患者におけるトリプルプロバイオティクス併用療法の代謝、酸化ストレス、および炎症パラメータへの影響：システマティックレビューとメタアナリシス

Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality. While various pharmacological and non-pharmacological treatment options are used, diabetes is still a non-treatable condition. Constant attempts are made to identify newer therapies that could support better management of the diabetes condition and improve overall quality of life. Numerous studies have supported the potential role of probiotics therapy in the diabetes condition.

To evaluate the efficacy of triple probiotic combination on glycaemic, metabolic, oxidative stress, and inflammatory parameters in the diabetic population.

Randomized controlled trials evaluating the efficacy of the triple probiotic combination in diabetic patients were identified. The quality of the studies was evaluated using the PEDro scale while biasness between and within the studies was assessed using the Risk of Bias tool. Meta-analysis was conducted using RevMan software, and sensitivity analysis was performed using OpenMeta Analyst software. The study protocol was registered in PROSPERO (CRD42024530999).

Five good-quality clinical trials were included. Low-to-moderate risk of bias was observed. Data from 300 participants were included (150 participants in both groups). Probiotics supplementation significantly improved glycaemic and insulin parameters (glucose level: -23.86 mg/dL; insulin level: -5.02 µIU/mL; HOMA-IR: -1.82 score; QUICKI: +0.02 score; HOMA-B: -16.30 score; P < 0.05 for all parameters), reduced oxidative stress and improved antioxidant parameters [TAC: +92.55 mmol/L; glutathione (GSH): +40.55 μmol/L; nitric oxide (NO): +6.45 μmol/L; malondialdehyde (MDA): -0.48 μmol/L; hs-CRP: -2.24 mg/L; P < 0.05 for all parameters except GSH], and improved lipid parameters (total cholesterol (TC): -3.43 mg/dL; triglycerides (TG): -4.26 mg/dL; low-density lipoprotein: -4.62 mg/dL; very low-density lipoprotein: -0.83 mg/dL; high-density lipoprotein (HDL): +1.83 mg/dL; TC/HDL ratio: -0.25; P < 0.05 for HDL and TC/HDL ratio parameters) compared to the control group.

The combination of L. acidophilus, L. casei, and B. bifidum is effective in diabetic patients with cardio/renal complications. Further well-designed studies are warranted to support the results of current research.