ABSTRACT

Probiotic supplementation in type 1 diabetes

Type 1 diabetes mellitus (T1DM), also known as insulin-dependent diabetes mellitus (IDDM), is a complex condition with multifactorial origin that involves a combination of genetic and environmental factors. T1DM is diagnosed early in life, usually in childhood, when an individual fails to meet the body requirements for insulin due to the development of an immune response directly against pancreatic β cells. Interestingly, T1DM patients have been reported to present dysbiosis of the gut microbiota, characterized by a decrease in Firmicutes and an increase in Bacteroidetes. The gut microbiota and the risk of T1DM are convincing, given that various studies have already demonstrated the relationship between disturbed glucose metabolism, immunity and the composition of the microbiota. Recently, there has been a growing research interest in probiotic supplementation as a potential strategy for improving T1DM prognosis through the modulation of the gut microbiota and immunity. The immunomodulatory and anti-inflammatory effects of probiotics may have a potential role in the prevention and treatment of T1DM. So far, clinical trials have demonstrated that the supplementation of probiotic strains, such as Lactobacillus johnsonii N6.2, Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12, especially early in life, may help to reduce T1DM risk and support conventional treatments. In addition, appropriate dietary changes, such as increasing prebiotic foods/dietary fibers (resistant starch, pectin, cellulose, and inulin), to support the growth of probiotic bacteria in the gut, may bring beneficial results.

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