Effect Of Probiotics On Glycemic Control In Patients With Type 2 Diabetes Mellitus:A Meta-analysis

Objective:To investigate the effect of probiotics on glycemic control in patients with type 2 diabetes mellitusMethods:PubMed,Embase,Cochrane Library,Web of Science,clinicaltrial.gov,cnki,and wanfang were searched.The retrieval time was from the establishment of the database to January 1,2019,and the retrieval language was not restricted.According to the preset inclusion and exclusion criteria,the retrieved literatures were screened and rescreened,and the included studies were finally determined.Risk of bias was assessed for the included studies using the risk of bias assessment tool for randomized controlled trials recommended by the Cochrane intervention systematic evaluation manual(5.1.0)and the RevMan 5.3 software.Relevant data were extracted from the studies that met the inclusion criteria,and the extracted data were input into the Stata 15.0 software for Meta analysis.The fixed effect model was used to summarize the data.The data of numerical variables were expressed as mean±SD,and 95%confidence intervals were listed.Heterogeneity of the included studies was analyzed using chi-square test(α=0.1)and evaluated using I~2statistics.Publication bias is judged visually by drawing funnel diagrams and quantitatively evaluated by Egger’s test by using Stata 15.0 software.Results:Twenty-one randomized controlled trials were included,including21 for fasting blood glucose,16 for glycosylated hemoglobin,11 for fasting plasma insulin,10 for homeostasis model assessment of insulin resistance index,and 7 for hypersensitive c-reactive protein.Compared with placebo,probiotics supplementation significantly reduced fasting blood glucose(SMD=-0.16;95%CI:-0.28,-0.04;p=0.007),glycosylated hemoglobin(SMD=-0.25;95%CI:-0.39,-0.12;p=0.000),fasting plasma insulin(SMD=-0.34;95%CI:-0.50,-0.18;p=0.000),and the insulin resistance index assessed by the homeostasis model(HOMA-IR)(SMD=-0.35;95%CI:-0.52,-0.19;p=0.000).There was no significant difference in hypersensitive c-reactive protein between the probiotics group and the control group(SMD=-0.08;95%CI:-0.27,-0.11;p=0.421).Conclusion:Probiotics supplementation can significantly reduce fasting blood glucose,glycosylated hemoglobin,fasting plasma insulin,and HOMA-IR,and may improve the clinical prognosis of type 2 diabetes.The modification of intestinal microflora by probiotics may be a new clinical method for the prevention and treatment of type 2 diabetes.