Potential mechanisms linking probiotics to diabetes: a narrative review of the literature.

Maryam Miraghajani,Sima Sabihi,Reza Ghiasvand,Sahar Golpour Hamedani,Somayeh Shahraki Dehsoukhteh,Nahid Rafie

doi:10.1590/1516-3180.2016.0311271216

Abstract

Some studies have suggested a wide range of possible mechanisms through which probiotics may play a role in diabetes prevention and treatment. However, the underlying mechanisms are not fully understood. We conducted this study to review the potential mechanisms suggested for the effect of probiotics in diabetes. Narrative review conducted at the Food Security Research Center of Isfahan. A search in the electronic databases MEDLINE (PubMed), Cochrane Library, Web of Science and Google scholar was performed up to October 2016. The initial search yielded 1214 reports. After removing duplicates, 704 titles and abstracts were screened. Finally, out of 83 full-text articles that were reviewed for eligibility, 30 articles were included in the final analysis. The anti-diabetic mechanisms for probiotics reported encompass intraluminal and direct effects on the intestinal mucosa and microbiota (n = 13), anti-inflammatory and immunomodulatory effects (n = 10), antioxidative effects (n = 5), effects on endoplasmic reticulum (ER) stress and expression of genes involved in glucose homeostasis and insulin resistance (n = 6), with some studies pointing to more than one mechanism. The results may throw some light on the capacity of probiotics as a novel approach towards controlling diabetes. However, further human studies are warranted to elucidate and confirm the potential role of probiotics in diabetes prevention and treatment. Also, it needs to be ascertained whether the effectiveness of probiotics in diabetes prevention and treatment is dependent on the strain of the microorganisms.

Highlights

Probiotics are live microorganisms that may exert beneficial effects regarding the sufficiency of consumption via their impact on the microbial balance of the gut.[1]
Given the various statements regarding the effects of probiotics on diabetes that have been made, the aim of the present study was to focus on possible mechanisms for probiotics that might explain some of their beneficial effects in relation to diabetes, in the form of a review
The search was last performed in October 2016, using combinations of search terms including “probiotics” OR “probiotic” OR “lactic acid bacteria” OR “lactobacillus” OR “lactobacilli” OR “bifidobacterium” OR “bifidobacteria” AND “diabetes mellitus”, without any restrictions, in order to find studies focusing on the mechanisms linking probiotics with diabetes

Summary

INTRODUCTION

Probiotics are live microorganisms that may exert beneficial effects regarding the sufficiency of consumption via their impact on the microbial balance of the gut.[1]. One of the main mechanisms postulated may involve increased glucagon-like peptide 1 (GLP-1) secretion from enteroendocrine L-cells to improve carbohydrate metabolism, decrease glucotoxicity and increase insulin sensitivity of target cells.[6] Other proposed mechanisms to explain the action of probiotics on diabetes relate to anti-inflammatory, antioxidant and immunomodulatory effects and alteration of the expression of some genes involved in diabetes.[7,8,9,10]. Given the various statements regarding the effects of probiotics on diabetes that have been made, the aim of the present study was to focus on possible mechanisms for probiotics that might explain some of their beneficial effects in relation to diabetes, in the form of a review

METHODS

RESULTS

DISCUSSION

CONCLUSIONS