Probiotics, a Novel and Efficient Adjuvant Therapy in Improving Glycemic Status: An Umbrella Meta-Analysis

OBJECTIVES: Probiotics exert several promoting effects on the glycemic status, however, the results of meta-analyses are inconsistent. As a result, this paper conducted an umbrella meta-analysis, across existing systematic reviews and meta-analyses of clinical trials to determine the definite effects of supplementation with probiotics on glycemic indices METHODS: Meta-analysis studies of randomized clinical trials examining the impacts of probiotics supplementation on glycemic indices were qualified in the current umbrella meta-analysis. A comprehensive systematic search of PubMed/Medline, Scopus, EMBASE, and Web of Science was carried out till August 2021. Effect sizes (ES) and corresponding confidence intervals (CIs) were employed to obtain the overall effect sizes. I(2) statistics and Cochrane's Q-test was used to detect the heterogeneity. The random-effects model was employed to conduct meta-analysis. RESULTS: 48 articles out of 693 in the literature search qualified for inclusion in the umbrella meta-analysis. Pooled effects of probiotics on fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin levels were reported in 45, 21, 35, and 33 articles, respectively. The analysis indicated a significant decrease of FPG (ES = −0.51 mg/dL; 95% CI: −0.63, −0.38, p < 0.001), HbA1c (ES = −0.32 mg/dL; 95% CI: −0.44, −0.20, p < 0.001), HOMA-IR (ES = −0.56; 95% CI: −0.66, −0.47, p < 0.001), and insulin levels (ES = −1.09 IU/mL; 95% CI: −1.37, −0.81, p = 0.006) by probiotics supplementation. CONCLUSIONS: Probiotics have amending effects on FPG, HbA1c, HOMA-IR, and insulin levels. A < 8-week period of probiotic supplementation in the moderate dosages (10(8) or 10(9) CFU) is an efficacious approach in improving glycemic parameters. Overall, probiotics could be recommended as an adjuvant anti-hyperglycemic agent. FUNDING SOURCES: None.