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Probiotics for Diabetes

Emma Bulbeck
DipCNM Nutritional Therapist

https://www.optibacprobiotics.com/uk/professionals/
latest-research/general-health/probiotics-for-diabetes
Growing research continues to demonstrate that the gut microbiome plays a pivotal role
in type 2 diabetes. Probiotics can help to modulate the immune system by correcting
underlying inflammation which can accelerate diabetes and lead to long-term health
complications. Improving metabolic function and the overall state of the gut
microbiome encourages the diversity and growth of beneficial bacterial species which
have been shown to lower fasting blood sugar. To find out more about the role our gut
microbiota play in our metabolic health, please see: Do gut microbes hold the key to
better metabolic health?

In this article, we will look at:

What is diabetes?
Are probiotics good for diabetics?
Should you be taking probiotics for diabetes?
Can analysing the gut microbiota predict diabetes risk?
Which probiotic is best for diabetes?
Key takeaways

What is diabetes?
Diabetes is a disease whereby the body's ability to regulate blood glucose is
compromised. It is one of the fastest-growing diseases in the UK and it’s estimated that
by 2025, 5 million people will have diabetes in the UK1.

Type 1 diabetes is an auto-immune condition usually occurring in younger individuals,

where the body's immune system attacks and destroys the insulin producing cells. This
may also be referred to as insulin-dependent diabetes as the body is not able to produce
insulin, so it must be taken. Type 2 diabetes is far more common, making up over 90% of
adults with diabetes in the UK and is due to the body not producing enough insulin to
regulate blood glucose or not being able to use the insulin that is produced (insulin
resistance). This type of diabetes is thought to be correlated to our modern diet and
lifestyle.

Could the rise in diabetes be caused by the 21st-century diet?

Are probiotics good for diabetics?

There is currently no evidence to suggest that diabetics should not take probiotics or
that they are unsafe for diabetics. However, diabetics do need to be aware of any
naturally occurring or added sugars that may be present in some probiotic
supplements. Some probiotics may contain prebiotics such as fructooligosaccharides
(FOS), which are a type of fibre (non digestible), so do not influence blood sugar levels.
However, if a sugar such as fructose was present, diabetes should factor this into their
daily intake.

There are di erent types of prebiotics, for example, Fructooligosaccharides (FOS) which
are non-digestible, so do not influence blood sugar levels and therefore would not need
to be considered by diabetics.

However, in some supplements, fructose is added to ensure an even distribution of

bacteria and prebiotic fibres. Fructose is a sugar and therefore diabetics may need to
factor this into their daily intake of carbohydrates, especially if taking multiple
supplements each day.

Please read the following article to learn more about the clinical trials that have been
conducted linking probiotics to better health outcomes: Probiotics: do they work, and
where’s the evidence?

Should you be taking probiotics for diabetes?

Emerging evidence suggests that changes in the gut microbiota might also play an
important role in the development of human metabolic disease. Due to this growing
research, it is certainly worth incorporating a live bacteria supplement into your daily
regime.

It is thought that metabolic disease may occur through a mechanism that is linked to
increased gut permeability, which can cause systemic low-grade inflammation.
Probiotics can help support many of the mechanisms linked to intestinal permeability,
which is thought to drive metabolic disease. For more information, please see: Could
probiotics help with leaky gut?

Another way in which probiotics are known to help with metabolic health is that they
increase the secretion of an intestinal hormone called glucagon-like peptide 1 (GLP-1)2,
which is critical for stimulating insulin secretion, and enables the proliferation and
regeneration of pancreatic beta cells that synthesise, store and release insulin.

A study from 2015, found that a er just 90 days of probiotic consumption, diabetic rats
were able to reduce their blood glucose levels in a similar way to the healthy rats3
(meaning that they were better able to produce insulin). Interestingly the blood glucose
levels in the healthy rats remained unchanged because those rats were already
managing their glucose and didn’t need more insulin.

Another study4 conducted in 2015, found that probiotic supplementation with

(Lactobacillus casei) may be useful in preventing insulin resistance caused by excessive
consumption of high-fat foods. The main finding of the study was that supplementation
with the LcS probiotic preserved glycaemic control and maintained the action of insulin.
These studies suggest that intervention with beneficial bacteria can help balance insulin
levels in both animals and humans. However, more research is needed as researchers
couldn't be sure as to the exact mechanism of how this was taking place.

Can analysing the gut microbiota predict

diabetes risk?
Did you know our bodies are home to more bacterial cells than human cells? Scientists
have begun to analyse the significance of the symbiotic relationship, and more
specifically; the impact that the bacteria have on our metagenome – the entire
collection of genes from ourselves and the microorganisms we share our body with.

It is well documented that those with type 2 diabetes have an entirely di erent
composition of gut microbiota than healthy people5. This over the years has led
researchers to develop a new model for early diagnosis, with better predictive value
than the model used currently, which uses body-mass index and waist-hip ratio.

This study suggests that by examining the patient’s gut microbiota, we can predict
which patients are at risk of developing diabetes. The question is – does the
composition of the gut microbiota promote the onset of age-related diabetes? If this is
the case, this would indicate new opportunities to prevent disease.

Further studies have been conducted to support this theory, suggesting that the
composition of intestinal bacteria changes over time in a negative way in those people
who are pre-diabetic and this could therefore possibly be a predictor of diabetes6. In
this particular study, researchers found that the men whose blood sugar control was
stable during the study had more gut bacteria that are considered beneficial for
metabolic health. On the other hand, those who were pre-diabetic didn’t have such a
healthy microbiota, or with fewer healthy bacteria and more harmful bacteria6 (o en
referred to as dysbiosis) which is an imbalance of gut bacteria. Furthermore, the men
who had improved glucose control over the course of the study were found to have
higher levels of Akkermansia, which is again associated with better metabolic health.

What these studies show us is that although there has been previous research linking
the balance of our gut bacteria with type 2 diabetes, this is the first piece of research to
suggest that the alteration in the composition of our gut bacteria can be seen in the
early stages of diabetes, or pre-diabetes. Going forward future studies need to be
conducted to determine if it is the changes in gut bacteria that can a ect the
development of type 2 diabetes. Otherwise, we will not know If the changes simply
reflect that the person is su ering from type 2 diabetes.

Changes in gut bacteria are thought to a ect the development of type 2 diabetes

Which probiotic is best for diabetes?

We know that an altered gut microbiota can contribute to the development of type 2
diabetes. Fascinating research has emerged to show that Metformin a widely available
drug used to treat type 2 diabetes has been shown to increase levels of a commensal
bacteria within the gut called Akkermansia muciniphila. This bacterium, as mentioned
previously is associated with reduced inflammation and improved metabolic health.
This once again demonstrates that the gut microbiota plays a crucial role in type 2
diabetes. 7, 8

Several probiotic strains have been shown to possess antidiabetic e ects, such as those
in Lactobacillus and Bifidobacterium genus because they improve biomarkers of
inflammation and oxidative stress and lower fasting blood glucose by promoting an
anti-inflammatory gut microbiota, which we know is linked to better metabolic health. 9,
10, 11.

Interestingly prebiotics have also been shown to support those with diabetes. In one
study participants who had recently been diagnosed with type 1 diabetes were given
high amylose starch which was shown to alter the gut microbiome profile, increasing
the production of health-promoting compounds called short-chain fatty acids (SCFA).
This resulted in improved glycemia, insulin sensitivity, and secretion.12 This increase in
gut bacterial diversity demonstrated improved glycemia just a er four weeks of
prebiotic consumption. For more information on this, please read: Uses of prebiotics.

Key takeaways
We have covered a lot in this article, so here is a summary of the main points:

It is well documented that those with type 2 diabetes have an entirely di erent
composition of gut microbiota than healthy people.
Examining the gut microbiota, could predict an individual’s risk of developing
diabetes.
Several probiotics have been shown to possess antidiabetic e ects.
Prebiotics have also been found to positively a ect metabolic health by improving
insulin sensitivity.

For further related reading, you might be interested in one of the following articles:

A look at zonulin and leaky gut syndrome

Gut Bacteria, Obesity & Mental Health

References

1. https://www.diabetes.org.uk/Documents/About%20Us/Statistics/Diabetes-key-stats-guidelines-
April2014.pdf

2. Ya Li. (2022). The e ects of probiotic administration on patients with prediabetes: a meta-analysis and
systematic review.

3. Duan FF, Liu JH, March JC.(2015) Engineered Commensal Bacteria Reprogram Intestinal Cells Into
Glucose-Responsive Insulin-Secreting Cells for the Treatment of Diabetes. Diabetes. Published online
January 27

4. Hulston C J, Churnside A A, Venables MC (2015)Probiotic supplementation prevents high-fat,

overfeeding-induced insulin resistance in human subjects British Journal of Nutrition, Published
online: 29 January 2015

5. Bäckhead, F. et al (2013) Gut metagenome in European women with normal, impaired and diabetic
glucose control. Nature.

6. Ciubotaru I, et al “Significant Di erences in fecal microbiotia are associated with various stages of
glucose tolerance in African-American male veterans” ENDO 2015; abstract FRI-597

7. Qin, J. et al (2012) A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature,
publish online ahead of print.

8. Hao Wu (2017) Metformin alters the gut microbiome of individuals with treatment-naive type 2
diabetes, contributing to the therapeutic.

9. Jacobo de la Cuesta-Zuluaga (2017) Metformin Is Associated With Higher Relative Abundance of

Mucin-Degrading Akkermansia muciniphila and Several Short-Chai. National Library of medicine.

10. Kaveh Naseri. (2018). Probiotics and synbiotics supplementation improve glycemic control
parameters in subjects with prediabetes and type 2 di. National Library of Medicine.

11. Hui Juan Zheng a (2019) The e ect of probiotic and synbiotic supplementation on biomarkers of
inflammation and oxidative stress in diabetic pat. Pharmacological Research. 142(0), pp.303-313.

12. Heba Ismail. (2022). LBSUN309 The E ect Of Prebiotics In Newly Diagnosed Youth With Type 1
Diabetes (T1D). National Library of Medicine.

Article Updated: 09 Aug 2023

Originally Published: 13 Jul 2023

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