The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials
Background: Nutritional interventions such as the use of prebiotics can promote eubiosis of gut microbiome and maintain glucose homeostasis in patients with type 2 diabetes (T2D). However, it would appear that results of the effects of prebiotics on the community of microbes in the gut are not consi...
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MDPI AG
2022-12-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/23/5139 |
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| author | Omorogieva Ojo Xiaohua Wang Osarhumwese Osaretin Ojo Joanne Brooke Yiqing Jiang Qingqing Dong Trevor Thompson |
| author_facet | Omorogieva Ojo Xiaohua Wang Osarhumwese Osaretin Ojo Joanne Brooke Yiqing Jiang Qingqing Dong Trevor Thompson |
| author_sort | Omorogieva Ojo |
| collection | DOAJ |
| description | Background: Nutritional interventions such as the use of prebiotics can promote eubiosis of gut microbiome and maintain glucose homeostasis in patients with type 2 diabetes (T2D). However, it would appear that results of the effects of prebiotics on the community of microbes in the gut are not consistent. Aim: To examine the effect of prebiotics and oral antidiabetic agents on gut microbiome in patients with T2D. Methods: The PRISMA Extension Statement for Systematic Reviews and Network Meta-analyses was used to conduct this review. Searches were carried out in EMBASE, EBSCO-host databases, Google Scholar and the reference lists of articles for studies that are relevant to the research question, from database inception to 15 August 2022. The search strategy was based on PICOS framework. Network Meta-analysis which allows the estimation of relative treatment effects by combing both direct trial evidence (e.g., treatment A vs. treatment B) and indirect evidence was conducted. Furthermore, pairwise meta-analysis was also carried out to estimate effect sizes based on head-to-head comparisons of treatments and/or control conditions. Results: Findings of the Network meta-analysis revealed that prebiotics significantly reduced HbA1c compared with control and the SMD was −0.43 [95% CI, −0.77, −0.08; <i>p</i> = 0.02], whereas there was no significant difference (<i>p</i> > 0.05) between the other treatments and control. In addition, anti-diabetic agents including glipizide and metformin also reduced HbA1C, although these were not significantly different (<i>p</i> > 0.05) from control. While prebiotics promoted <i>Bifidobacterium</i> and <i>Akkermansia</i>, the improvements were not significantly different (<i>p</i> > 0.05) from control. On the other hand, metformin decreased the relative abundance of <i>Bifidobacterium</i>, but increased <i>Lactobacillus</i> and <i>Akkermansia</i>, although the differences were not significant (<i>p</i> > 0.05) compared with control. With respect to fasting blood glucose and BMI, the effects of prebiotics and oral antidiabetic agents did not differ significantly (<i>p</i> > 0.05) from controls. Conclusions: The findings of the systematic review and Network meta-analysis demonstrated prebiotics were significantly (<i>p</i> < 0.05) more effective in reducing HbA1c than control in patients with T2D. However, the effects of prebiotics and oral antidiabetic agents did not differ significantly (<i>p</i> > 0.05) from the controls in relation to fasting blood glucose, post-prandial blood glucose, body mass index and the genera of gut bacteria examined. More studies are required to fully investigate the effects of prebiotics and oral antidiabetic agents in patients with T2D |
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| language | English |
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| spelling | doaj.art-ff0a4c60c98b48d4a6587490ff6209352023-11-24T11:52:47ZengMDPI AGNutrients2072-66432022-12-011423513910.3390/nu14235139The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled TrialsOmorogieva Ojo0Xiaohua Wang1Osarhumwese Osaretin Ojo2Joanne Brooke3Yiqing Jiang4Qingqing Dong5Trevor Thompson6School of Health Sciences, Avery Hill Campus, University of Greenwich, London SE9 2UG, UKThe School of Nursing, Soochow University, Suzhou 215006, ChinaSmoking Cessation Department, University Hospital, London SE13 6LH, UKFaculty of Health, Education and Life Sciences, Birmingham City University, Birmingham B15 3TN, UKThe School of Nursing, Soochow University, Suzhou 215006, ChinaThe School of Nursing, Soochow University, Suzhou 215006, ChinaSchool of Human Sciences, Avery Hill Campus, University of Greenwich, London SE9 2UG, UKBackground: Nutritional interventions such as the use of prebiotics can promote eubiosis of gut microbiome and maintain glucose homeostasis in patients with type 2 diabetes (T2D). However, it would appear that results of the effects of prebiotics on the community of microbes in the gut are not consistent. Aim: To examine the effect of prebiotics and oral antidiabetic agents on gut microbiome in patients with T2D. Methods: The PRISMA Extension Statement for Systematic Reviews and Network Meta-analyses was used to conduct this review. Searches were carried out in EMBASE, EBSCO-host databases, Google Scholar and the reference lists of articles for studies that are relevant to the research question, from database inception to 15 August 2022. The search strategy was based on PICOS framework. Network Meta-analysis which allows the estimation of relative treatment effects by combing both direct trial evidence (e.g., treatment A vs. treatment B) and indirect evidence was conducted. Furthermore, pairwise meta-analysis was also carried out to estimate effect sizes based on head-to-head comparisons of treatments and/or control conditions. Results: Findings of the Network meta-analysis revealed that prebiotics significantly reduced HbA1c compared with control and the SMD was −0.43 [95% CI, −0.77, −0.08; <i>p</i> = 0.02], whereas there was no significant difference (<i>p</i> > 0.05) between the other treatments and control. In addition, anti-diabetic agents including glipizide and metformin also reduced HbA1C, although these were not significantly different (<i>p</i> > 0.05) from control. While prebiotics promoted <i>Bifidobacterium</i> and <i>Akkermansia</i>, the improvements were not significantly different (<i>p</i> > 0.05) from control. On the other hand, metformin decreased the relative abundance of <i>Bifidobacterium</i>, but increased <i>Lactobacillus</i> and <i>Akkermansia</i>, although the differences were not significant (<i>p</i> > 0.05) compared with control. With respect to fasting blood glucose and BMI, the effects of prebiotics and oral antidiabetic agents did not differ significantly (<i>p</i> > 0.05) from controls. Conclusions: The findings of the systematic review and Network meta-analysis demonstrated prebiotics were significantly (<i>p</i> < 0.05) more effective in reducing HbA1c than control in patients with T2D. However, the effects of prebiotics and oral antidiabetic agents did not differ significantly (<i>p</i> > 0.05) from the controls in relation to fasting blood glucose, post-prandial blood glucose, body mass index and the genera of gut bacteria examined. More studies are required to fully investigate the effects of prebiotics and oral antidiabetic agents in patients with T2Dhttps://www.mdpi.com/2072-6643/14/23/5139prebioticsoral anti-diabetic agentsgut microbiomeglycated haemoglobintype 2 diabetesNetwork meta-analysis |
| spellingShingle | Omorogieva Ojo Xiaohua Wang Osarhumwese Osaretin Ojo Joanne Brooke Yiqing Jiang Qingqing Dong Trevor Thompson The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials Nutrients prebiotics oral anti-diabetic agents gut microbiome glycated haemoglobin type 2 diabetes Network meta-analysis |
| title | The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials |
| title_full | The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials |
| title_fullStr | The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials |
| title_full_unstemmed | The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials |
| title_short | The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials |
| title_sort | effect of prebiotics and oral anti diabetic agents on gut microbiome in patients with type 2 diabetes a systematic review and network meta analysis of randomised controlled trials |
| topic | prebiotics oral anti-diabetic agents gut microbiome glycated haemoglobin type 2 diabetes Network meta-analysis |
| url | https://www.mdpi.com/2072-6643/14/23/5139 |
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