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Metabolic effects of Lactobacillus reuteri DSM 17938 in people with type 2 diabetes: A randomized controlled trial.

  • 2017-02-07
  • Diabetes, obesity & metabolism 19(4)
    • Reza Mobini
    • Valentina Tremaroli
    • Marcus Ståhlman
    • Fredrik Karlsson
    • Max Levin
    • Maria Ljungberg
    • Maja Sohlin
    • Heléne Bertéus Forslund
    • Rosie Perkins
    • Fredrik Bäckhed
    • Per-Anders Jansson

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 46
Population
46 people with type 2 diabetes on insulin therapy
Methods
Double-blind trial, randomized to placebo or low (10^8 CFU/d) or high dose (10^10 CFU/d) of L. reuteri DSM 17938 for 12 weeks
Blinding
Double-blind
Duration
12 weeks
Funding
Unclear
  • Highly Cited

Aims

To investigate the metabolic effects of 12-week oral supplementation with Lactobacillus reuteri DSM 17938 in patients with type 2 diabetes on insulin therapy.

Materials and methods

In a double-blind trial, we randomized 46 people with type 2 diabetes to placebo or a low (108  CFU/d) or high dose (1010  CFU/d) of L. reuteri DSM 17938 for 12 weeks. The primary endpoint was the effect of supplementation on glycated haemoglobin (HbA1c). Secondary endpoints were insulin sensitivity (assessed by glucose clamp), liver fat content, body composition, body fat distribution, faecal microbiota composition and serum bile acids.

Results

Supplementation with L. reuteri DSM 17938 for 12 weeks did not affect HbA1c, liver steatosis, adiposity or microbiota composition. Participants who received the highest dose of L. reuteri exhibited increases in insulin sensitivity index (ISI) and serum levels of the secondary bile acid deoxycholic acid (DCA) compared with baseline, but these differences were not significant in the between-group analyses. Post hoc analysis showed that participants who responded with increased ISI after L. reuteri supplementation had higher microbial diversity at baseline, and increased serum levels of DCA after supplementation. In addition, increases in DCA levels correlated with improvement in insulin sensitivity in the probiotic recipients.

Conclusions

Intake of L. reuteri DSM 17938 for 12 weeks did not affect HbA1c in people with type 2 diabetes on insulin therapy; however, L. reuteri improved insulin sensitivity in a subset of participants and we propose that high diversity of the gut microbiota at baseline may be important.

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