Microbiota fecal de pacientes com diabetes mellitus tipo 2 após uso de probióticos: uma revisão sistemática e metanálise

Abstract

Background: The incidence of diabetes mellitus has risen sharply and its prevalence poses a major threat to global health. The human gut microbiota refers to microbes that colonize the gut and participate in various functions that benefit the host. Studies suggest that probiotics can be administered in alterations of the diabetic microbiome to restore the composition of the intestinal microflora. This systematic review aims to identify and evaluate the scientific evidence of the effects of supplementation with probiotics on the composition of the gastrointestinal microbiota of adults with type 2 diabetes mellitus. Methods: Systematic review was conducted with the aim of evaluating the results of Randomized Clinical Trials (RCTs) on intestinal microbial changes in people with type 2 diabetes mellitus after administration of probiotics. Five literature databases were considered (EMBASE, MEDLINE, ISI - Web of Science, Scopus and CENTRAL). The protocol that delimits this work was registered in PROSPERO (International Prospective Register of Systematic Reviews). Results: 973 records were identified during the literature search. After reviewing the titles and abstracts, 58 publications were selected for the complete reading of the texts, of which only 4 met the selection criteria and were included for meta-analysis. The methodological quality analysis classified 2 studies as "high risk of bias", 1 as "some concerns" and 1 as "low risk of bias". The 4 studies showed changes in some genera of bacteria after intervention with probiotics. Conclusions: The results obtained from this systematic review and meta-analysis suggest that the effect of probiotic supplements on the intestinal microbiota of diabetic patients has been inconclusive and that a larger quantity of Randomized Clinical Trials is needed to expand the number of participants, with a longer time interval and to provide detailed information on the diversity of the gut microbiota to fully assess the size of the effect of this therapy in the treatment of type 2 diabetes mellitus.