ESPE Abstracts

Background: Studies in animal models and humans with type 1 diabetes mellitus (T1DM) have shown that probiotic supplementation leads to decreased proinflammatory cytokines (responsible for damaging β-cells of the pancreas), improved gut barrier function, and induction of immune tolerance.

Objective: To study the effect of supplementation of probiotics in children with T1DM on glycemic control, insulin total daily dose (TDD) and lipid profile.

Subjects and Methods: A single-centered, double-blinded, and randomized controlled trial was conducted in children (2–12 years) with T1DM (mean diabetes duration: 4.91 ± 2.11 years). Ninety children (45 in each group) were randomized and allocated to control or intervention groups. The intervention group received oral probiotics containing lactobacillus acidophilus La-14 (108 CFU) 0.5 mg once daily for 3 months. Both groups were followed-up for 6 months with assessment of HbA1c, mean blood glucose (MBG), insulin TDD, and lipid profile.

Results: Both groups were well-matched regarding baseline clinical characteristics and laboratory parameters (p > 0.05). At 3 months following the intervention, there was a significant decline in MBG (170 vs. 187 mg/dl; P=0.05), and insulin TDD (1.1 vs. 1.4 U/kg/day; P= 0.04). However, there was no significant change in HbA1c % (9.8 vs. 10.2 %; P= 0.2). At 6 months following the intervention, we found a significant decrease in MBG (145 vs. 192 mg/dl; P=0.003), HbA1c % (8 vs. 10.5 %; P=0.002) and a significant decline in insulin TDD (0.9 vs. 1.3 U/kg/day; P= 0.006) in the intervention group when compared with the control group. Serum triglycerides, total cholesterol, and LDL were significantly decreased in the probiotics group than control group (121 vs. 188, 213 vs 318, 113 vs. 149 mg/dl; P=0.001, respectively). Serum HDL was significantly increased in the probiotics group (76 vs. 43 mg/dl; P=0.001).

Conclusion: Probiotics supplementation improved blood glucose levels, glycemic control, and lipid profile. Thus, probiotics could be an effective adjuvant therapy in children with T1DM. However, more studies with an extended intervention period are warranted to assess probiotics' sustained effect over time.