The Journal of Clinical Endocrinology and Metabolism Journal Article

Effect of Prebiotic on Microbiota, Intestinal Permeability, and Glycemic Control in Children With Type 1 Diabetes

June 12, 2019

Josephine Ho, Alissa C Nicolucci, Heidi Virtanen, Alana Schick, Jon Meddings, Raylene A Reimer, Carol Huang
The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 10, October 2019, Pages 4427–4440
https://doi.org/10.1210/jc.2019-00481

Abstract

Context

Patients with type 1 diabetes (T1D) have lower microbiota diversity and distinct gut microbial profiles that have been linked to changes in intestinal permeability. Prebiotics are nondigestible carbohydrates that alter gut microbiota and could potentially improve glycemic control and reduce intestinal permeability and thereby insulin sensitivity.

Objective

To determine the effect of prebiotics on glycemic control, gut microbiota, and intestinal permeability in children with T1D.

Design

A randomized, placebo-controlled trial in children 8 to 17 years of age with T1D using placebo or prebiotic oligofructose-enriched inulin for 12 weeks. Baseline, 3-month, and 6-month assessments included HbA1c, C-peptide, gut microbiota, intestinal permeability, frequency of diabetic ketoacidosis (DKA), and severe hypoglycemia.

Results

Forty-three subjects were randomized and 38 completed the study. The groups were similar at baseline: prebiotic (N = 17), age 12.5 years (SD of 2.8), HbA1c 8.02% (SD of 0.82); placebo (N = 21), age 12.0 years (SD of 2.6), HbA1c 8.08% (SD of 0.91). No significant differences were found in the frequency of DKA or severe hypoglycemia. At 3-months, C-peptide was significantly higher (P = 0.029) in the group who received prebiotics, which was accompanied by a modest improvement in intestinal permeability (P = 0.076). There was a significant increase in the relative abundance of Bifidobacterium within the prebiotic group at 3 months that was no longer present after the 3-month washout. The placebo group had significantly higher relative abundance of Streptococcus, Roseburia inulinivorans, Terrisporobacter, and Faecalitalea compared with the prebiotic group at 3 months.

Conclusion

Prebiotics are a potentially novel, inexpensive, low-risk treatment addition for T1D that may improve glycemic control. Further larger-scale trials are needed.

Read the article


You may also like...

JCEM

New Year, New Look

JCEM
JCEM, the most-cited journal in Endocrinology & Metabolism, has a new look for 2020. Check out the latest published articles and sign-up for advanced article alerts today.

Same Great Science

JCEM, the most-cited journal in Endocrinology & Metabolism, has a new look for 2020. Check out the latest published articles and sign-up for advanced article alerts today.

Thematic Issue

Immuno-endocrinology 2020

immuno-endocrinology
Read our special collection of journal articles, published in 2018-2019, focused on immuno-endocrinology! Curation of the collection was guided by Altmetric Attention Scores and Featured Article designations.

Read our special collection of journal articles, published in 2018-2019, focused on immuno-endocrinology! Curation of the collection was guided by Altmetric Attention Scores and Featured Article designations.

Back to top
Short on time?

We'll come to you...

Get updates on the latest breakthroughs, clinical practice guidelines, and career development opportunities, straight to your inbox

Then take the next step: Set up your free website account and get exclusive access to even more great tools & content!