Probiotic for Pancreatic β-Cell Function in Type 2 Diabetes: A Randomized, Double-Blinded, PlaceboControlled Clinical Trial

Introduction: Many clinical studies have proved the effectiveness of probiotics in metabolic disorders associated with insulin resistance. However, the impact of probiotic therapy on pancreatic beta-cell function is ambiguous. The influence of probiotic supplementation vs. placebo on beta-cell function in people with type 2 diabetes (T2D) was assessed in a double-blind, single-center, randomized, placebo-controlled trial (RCT). Methods: Sixty-eight patients with T2D were selected for participation in the RCT. Patients were randomly allocated to consumption of live multistrain probiotics or a placebo for 8 weeks, administered as a sachet formulation in double-blind treatment. The primary main outcome was the assessment of beta-cell function as change in C-peptide and HOMA-beta (homeostasis model assessment-estimated beta-cell function), which was calculated using the HOMA2 calculator (Diabetes Trials Unit, University of Oxford). Secondary outcomes were the changes in glycemic control-related parameters, anthropomorphic variables, and cytokines levels. Analysis of covariance was used to assess the difference between groups. Results: Supplementation with live multiprobiotic was associated with slight significant improvement of beta-cell function (HOMA-beta increased from 32.48 +/- 13.12 to 45.71 +/- 25.18; p = 0.003) and reduction of fasting glucose level (13.03 +/- 3.46 vs 10.66 +/- 2.63 mmol/L and 234.63 +/- 62.36 vs 192.07 +/- 47.46 mg/dL; p\ 0.001) and HbA1c (8.86 +/- 1.28 vs 8.48 +/- 1.22; p = 0.043) as compared to placebo. Probiotic therapy significantly affects chronic systemic inflammation in people with T2D by reducing pro-inflammatory cytokine levels. Conclusions: Probiotic therapies modestly improved beta-cell function in patients with T2D. Modulating the gut microbiota represents a new