PMID- 37369280
OWN - NLM
STAT- MEDLINE
DCOM- 20230807
LR  - 20230807
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 202
DP  - 2023 Aug
TI  - Effects of combined treatment of probiotics and metformin in management of type 2 
      diabetes: A systematic review and meta-analysis.
PG  - 110806
LID - S0168-8227(23)00569-7 [pii]
LID - 10.1016/j.diabres.2023.110806 [doi]
AB  - BACKGROUND: Lifestyle changes and dietary intervention, including the use of 
      probiotics, can modulate dysbiosis of gut microbiome and contribute to the 
      management of type 2 diabetes mellitus (T2DM). This systematic review and 
      meta-analysis aim to assess the efficacy of metformin plus probiotics versus 
      metformin alone on outcomes in patients with T2DM. METHODS: We searched MEDLINE 
      and EMBASE from inception to February 2023 to identify all randomized controlled 
      trials (RCTs), which compared the use of metformin plus probiotics versus 
      metformin alone in adult patients with T2DM. Data were summarized as mean 
      differences (MD) with 95 % confidence interval (CI) and pooled under the random 
      effects model. FINDINGS: Fourteen RCTs (17 comparisons, 1009 patients) were 
      included in this systematic review. Pooled results show a significant decrease in 
      fasting glucose (FG) (MD = -0.64, 95 % CI = -1.06, -0.22) and HbA1c (MD = -0.29, 
      95 % CI = -0.47, -0.10) levels in patients with T2DM treated with metformin plus 
      probiotics versus metformin alone. The addition of probiotics to metformin 
      resulted in lower odds of gastrointestinal adverse events (Odds ratio = 0.18, 
      95 % CI = 0.09, 0.3.8; I(2) = 0 %). CONCLUSIONS: The addition of probiotics to 
      metformin therapy is associated with improvement in T2DM outcomes. However, 
      high-quality and adequately reported RCTs are needed in the future to confirm our 
      findings.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Memon, Hamda
AU  - Memon H
AD  - College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United 
      Arab Emirates.
FAU - Abdulla, Fatima
AU  - Abdulla F
AD  - College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United 
      Arab Emirates.
FAU - Reljic, Tea
AU  - Reljic T
AD  - Research Methodology and Biostatistics Core, Morsani College of Medicine, 
      University of South Florida, Tampa, FL, USA.
FAU - Alnuaimi, Saif
AU  - Alnuaimi S
AD  - College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United 
      Arab Emirates.
FAU - Serdarevic, Fadila
AU  - Serdarevic F
AD  - Sarajevo Medical School, University Sarajevo School of Science and Technology, 
      Sarajevo, Bosnia and Herzegovina; Department of Child and Adolescent Psychiatry, 
      Erasmus University Medical Center, Rotterdam, Netherlands.
FAU - Asimi, Zelija Velija
AU  - Asimi ZV
AD  - Sarajevo Medical School, University Sarajevo School of Science and Technology, 
      Sarajevo, Bosnia and Herzegovina.
FAU - Kumar, Ambuj
AU  - Kumar A
AD  - Research Methodology and Biostatistics Core, Morsani College of Medicine, 
      University of South Florida, Tampa, FL, USA.
FAU - Semiz, Sabina
AU  - Semiz S
AD  - College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United 
      Arab Emirates. Electronic address: sabina.semiz@ku.ac.ae.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230625
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 9100L32L2N (Metformin)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Metformin/therapeutic use
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Diabetes Mellitus, Type 2/drug therapy/chemically induced
MH  - *Probiotics/therapeutic use
MH  - Fasting
OTO - NOTNLM
OT  - Fasting glucose
OT  - Fasting insulin
OT  - Gastrointestinal intolerance
OT  - HbA1c
OT  - Insulin resistance
OT  - Lipids
OT  - Metformin
OT  - Probiotic
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/06/28 01:06
MHDA- 2023/08/07 06:42
CRDT- 2023/06/27 19:10
PHST- 2023/05/23 00:00 [received]
PHST- 2023/06/22 00:00 [accepted]
PHST- 2023/08/07 06:42 [medline]
PHST- 2023/06/28 01:06 [pubmed]
PHST- 2023/06/27 19:10 [entrez]
AID - S0168-8227(23)00569-7 [pii]
AID - 10.1016/j.diabres.2023.110806 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2023 Aug;202:110806. doi: 10.1016/j.diabres.2023.110806. 
      Epub 2023 Jun 25.