Diabetes Mellitus ve Probiyotik, Prebiyotik, Simbiyotikler

Abstract

Diyabet, pankreatik insülin üretiminin azalması veya tipik olarak insülin sinyaline yanıt veren dokularda azalmış insülin duyarlılığının bir sonucu olarak ortaya çıkan yüksek kan şekeri seviyeleri ile karakterize kronik metabolik hastalıktır. Bağırsak mikrobiyotası, azalmış glikoz toleransı ve insülin direnci yoluyla diyabet, obezite, metabolik sendromun ortaya çıkmasıyla bağlantılıdır ve metabolitleri ve bakteriyel bileşenleri, inflamasyonu, bağışıklığı ve metabolizmayı düzenleyerek diyabetin başlamasını ve ilerlemesini etkilemektedir. Bağırsak mikrobiyotasının disbiyozu, öncelikle bakteri ve mantarların, özellikle işlev bozukluğu ve çeşitli patolojilerle ilişkili olanların çeşitliliği ve miktarının azalmasıyla karakterizedir ve bu durum, inflamatuar süreç, insülin direnci ve inkretin sekresyonunun etkisiyle kardiyovasküler, nöronal, immün ve metabolik bozukluklara neden olmaktadır. Mikrobiyotanın modülasyonu için en önemli faktör beslenmedir ve son yıllarda yapılan çalışmalarla prebiyotik ve probiyotikler ile mikrobiyotayı düzenlemenin mümkün olduğu gösterilmektedir. Probiyotik, prebiyotik ve simbiyotikler, diyabetik hastalarda inflamatuar süreçleri azaltmada, insülin duyarlılığını ve pankreas β-hücre fonksiyonlarını iyileştirerek kan şekeri homeostazını sağlamada görev almaktadır. Bağırsak mikrobiyomu ve diyabet arasındaki etkileşimi anlamak, diyabet için terapötiklerin geliştirilmesine yeni bir bakış açısı sağlayacaktır.

Keywords

• Diyabet
• mikrobiyota
• probiyotik
• prebiyotik
• simbiyotik

Diabetes Mellitus and Probiotic, Prebiotic, Symbiotics

Abstract

Diabetes is a group of chronic metabolic diseases characterized by elevated blood sugar levels that occur as a result of decreased pancreatic insulin production or decreased insulin sensitivity in tissues that typically respond to insulin signaling. The gut microbiota is linked to the emergence of diabetes, obesity, metabolic syndrome through reduced glucose tolerance and insulin resistanc and also it’s metabolites and bacterial components affect the onset and progression of diabetes by regulating inflammation, immunity, and metabolism. Dysbiosis of the intestinal microbiota is characterized primarily by a decrease in the diversity and quantity of bacteria and fungi, especially those associated with dysfunction and various pathologies and with this, the inflammatory process causes cardiovascular, neuronal, immune and metabolic disorders with the effect of insulin resistance and incretin secretion. Nutrition is the most important factor for the modulation of the microbiota, and recent studies have shown that it is possible to regulate the microbiota with prebiotics and probiotics. Probiotics, prebiotics and symbiotics play a role in reducing inflammatory processes in diabetic patients, improving insulin sensitivity and pancreatic β-cell functions, and maintaining blood sugar homeostasis. Understanding the interaction between the gut microbiome and diabetes will provide new insight into the development of therapeutics for diabetes.

Keywords

• Diabetes
• microbiota
• probiotic
• prebiotic
• symbiotic

References

1. 1Saeedi P, Petersohn I, Salpea P, Malandaa B, Karurangaa S, Unwinb N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.
2. Zhang L, Chu J, Hao W, Zhang J, Li H, Zang C, Yang J, Chen X, Wang H. Gut microbiota and type 2 diabetes mellitus: association, mechanism, and translational, applications. Mediators Inflamm. 2021;2021:12.
3. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol. 2018; 6(1): 69- 80.
4. Panwar H, Rashmi HM, Batish VK, Grover S. Probiotics as potential biotherapeutics in the management of type 2 diabetes - prospects and perspectives. Diabetes Metab Res Rev. 2013;29(2):103-12.
5. Lv Y, Qin X, Jia H, Chen S, Sun W, Wang X. The association between gut microbiota composition and BMI in Chinese male college students, as analysed by next-generation sequencing. Br J Nutr. 2019;122(9):986-995.
6. Munoz-Garach A, Diaz-Perdigones C, Tinahones FJ. Gut microbiota and type 2 diabetes mellitus. Endocrinología y nutrición. 2016;63(10):560-568.
7. Kamarlı H. Pre- Probiyotikler ve Diyabet. Beslenme ve Diyet Dergisi,2019;47:92-101.
8. Aoun A, Darwish F, Hamod. The ınfluence of the gut microbiome on obesity in adults and the role of probiotics, prebiotics, and synbiotics for weight loss. Prev Nutr Food Sci. 2020;25(2):113-123.

9. Charbonneau MR, Blanton LV, DiGiulio DB, Relman DA, Lebrilla CB, Mills DA, ve ark. A microbial perspective of human developmental biology. Nature. 2016;535:48-55.
10. DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current understanding of dysbiosis in disease in human and animal models. Inflamm Bowel Dis. 2016;22:1137.
11. Tilg H, Moschen AR. Microbiota and diabetes: an evolving relationship. Gut. 2014;63:1513–21.
12. Vallianou NG, Stratigou T, Tsagarakis S. Microbiome and diabetes: Where are we now?. Diabetes Res Clin Pract. 2018;146:111-118.
13. Yoo JY, Kim SS. Probiotics and Prebiotics: Present status and future perspectives on metabolic disorders. Nutrients. 2016;8(3):173.
14. Knip M, Siljander H. The role of the intestinal microbiota in type 1 diabetes mellitus. Nat Rev Endocrinol. 2016;12:154-167.
15. Blandino G, Inturri R, Lazzara F, Di Rosa M, Malaguarnera L. Impact of gut microbiota on diabetes mellitus. Diabetes Metab. 2016;42(5):303-315.
16. Pellegrini S, Sordi V, Bolla AM, Saita D, Ferrarese R, Canducci F, et al. Duodenal mucosa of patients with type 1 diabetes shows distinctive inflammatory profile and microbiota. J Clin Endocrinol Metabol. 2017;102(5):1468-1477.
17. Yadav M, Verma KM, Chauhan NS. A review of metabolic potential of human gut microbiome in human nutrition. Arch Microbiol. 2018;200:203-217.
18. Shi H, Kokoeva MV, Inouye L, Tzameli I, Yin H, Flier JS. TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest. 2006; 116:3015-3025.
19. Gomes J, Costa JA, Alfenas R. Metabolic endotoxemia and diabetes mellitus: a systematic review. Metabolism. 2017;68:133–144.
20. Sanna S, van Zuydam NR, Mahajan A, Kurilshikov A, Vich Vila A, Võsa U, et al. Causal relationships among the gut microbiome, shortchain fatty acids and metabolic diseases. Nat Genet. 2019;51:600–605.
21. World Gastroenterology Organisation. Probiotics and prebiotics. Web site. http://www.worldgastroenterology.org/guidelines/globalguidelines/probiotics-and-prebiotics/probioticsand-prebiotics-english. Published 2017. Accessed November 15, 2022.
22. Yıldırım E. Yoğurt, probiyotik yoğurt ve kefir tüketiminin hipertansiyon üzerine etkisi (Doktora Tezi). Erciyes Üniversitesi Fen Bilimleri Enstitüsü, Gıda Mühendisliği Anabilim Dalı, 2016.
23. Göçer EMÇ, Ergin F, Küçükçetin A. Sindirim Sistemi Modellerinde Probiyotik Mikroorganizmaların Canlılığı. Akademik Gıda. 2016;14:158-165.
24. Kalip K, Atak,N. Bağırsak mikrobiyotası ve sağlık. Turkish Journal of Public Health. 2018;16:58.
25. Patel R, DuPount HL. New Approaches for Bacteriotherapy: Prebiotics, New-Generation Probiotics, and Synbiotics. Clin Infect Dis. 2015;60:108–121.
26. Le Barz M, Anhe FF, Varin TV, Desjardins Y, Levy E, Roy D, et al. Probiotics as complementary treatment for metabolic disorders. Diabetes Metab J. 2015;39(4):291-303.
27. Zaborska KE, Cummings BP. Rethinking bile acid metabolism and signaling for type 2 diabetes treatment. Curr Diab Rep. 2018;18:109.
28. Sato J, Kanazawa A, Azuma K, Ikeda F, Goto F, Komiya K, et al. Probiotic reduces bacterial translocation in type 2 diabetes mellitus: A randomised controlled study. Sci Rep. 2017;7:12115.
29. Gargari G, Taverniti V, Koirala R, Gardana C, Guglielmetti S. Impact of a multistrain probiotic formulation with high bifidobacterial content on the fecal bacterial community and short-chain fatty acid levels of healthy adults. Microorganisms, 2020;8(4):492.
30. Hsieh MC, Tsai WH, Jheng YP, Su SL, Wang SY, Lin CC, et al. The beneficial effects of Lactobacillus reuteri ADR-1 or ADR-3 consumption on type 2 diabetes mellitus: A randomized, double-blinded, placebo-controlled trial. Sci Rep. 2018;8:16791.
31. Tonuccia LB, dos Santos KMO, de Oliveira LL, Ribeiro SMR, Hercia Stampini Duarte Martinod HSD. Clinical application of probiotics in type 2 diabetes mellitus: A randomized, double-blind, placebo-controlled study. Clin Nutr. 2017;36(1):85- 92.
32. Soleimani A, Zarrati Mojarrad M, Bahmani F, Taghizadeh M, Ramezani M, Tajabadi-Ebrahimi M, et al. Probiotic supplementation in diabetic hemodialysis patients has beneficial metabolic effects. Kidney Int, 2017;91(2):435–442.
33. Mafi A, Namazi G, Soleimani A, Bahmani F, Aghadavod E, Asemi Z. Metabolic and genetic response to probiotics supplementation in patients with diabetic nephropathy: A randomized, doubleblind, placebo-controlled trial. Food Funct. 2018;9:4763–4770.
34. Tao YW, Gu YL, Mao XQ, Zhang L, Pei YF. Effects of probiotics on type II diabetes mellitus: a meta-analysis. J Transl Med. 2020;18:30.
35. Ardeshirlarijani E, Tabatabaei-Malazy O, Mohseni S, Qorbani M, Larijani B, Baradar Jalili R. Effect of probiotics supplementation on glucose and oxidative stress in type 2 diabetes mellitus: a meta-analysis of randomized trials. Daru. 2019;27:827–837.
36. Sun J, Buys NJ. Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials. Br J Nutr. 2016;115(7):1167–1177.
37. Ricke SC. Prebiotics and alternative poultry production. Poult Sci. 2021;100(7):101174.
38. Ahmed W, Rashid S. Functional and therapeutic potential of inulin: a comprehensive review. Crit Rev Food Sci Nutr. 2019;59(1):1–13.
39. Wang L, Huang H, Zhang C, Zuo HX, Xu P, Niu YM, et al. Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose–response meta-analysis of 33 randomized controlled trials. J Transl Med. 2019;17:410.
40. Jafarnejad S, Saremi S, Jafarnejad F, Arab A. Effects of a multispecies probiotic mixture on glycemic control and inflammatory status in women with gestational diabetes: a randomized controlled clinical trial. J Nutr Metab. 2016;2016:5190846.
41. Liu F, Prabhakar M, Ju J, Long H, Zhou HW. Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2017;71:9–20.
42. Aliasgharzadeh A, Dehghan P, Gargari BP, Asghari-Jafarabadi M. Resistant dextrin, as a prebiotic, improves insulin resistance and inflammation in women with type 2 diabetes: a randomised controlled clinical trial. Br J Nutr. 2015;113(2):321-330.
43. Gibb RD, McRorie JW, Jr. Russell DA, Hasselblad V, D’Alessio A. Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Am J Clin Nutr. 2015;102(6):1604-1614.
44. Wang X, Yang J, Qiu X, Wen Q, Liu M, Zhou D, et al. Probiotics, Pre-biotics and Synbiotics in the Treatment of Pre-diabetes: A Systematic Review of Randomized Controlled Trials. Front Public Health, 2021;9:645035.
45. Manigandan T, Mangaiyarkarasi SP, Hemalatha R, Hemalatha VT, Murali NP. Probiotics, prebiotics, and synbiotics-a review. Biomedical & Pharmacology Journal. 2012;5:295–304.
46. Kassaian N, Feizi A, Aminorroaya A, Amini M. Probiotic and synbiotic supplementation may improve metabolic syndrome in prediabetic adults: a randomized controlled trial. Diyabet Metab Syndr. 2018;13(5):2991–2996.
47. Patricia M, Bock Telo GH, Ramalho R, Sbaraini M, Leivas G, Martins AF, et al. The effect of probiotics, prebiotics or synbiotics on metabolic outcomes in individuals with diabetes: a systematic review and meta-analysis. Diabetologia. 2020;64:26–41.
48. Asemi Z, Alizadeh SA, Ahmad K, Goli M, Esmaillzadeh A. Effects of beta-carotene fortified synbiotic food on metabolic control of patients with type 2 diabetes mellitus: a double-blind randomized cross-over controlled clinical trial. Clin Nutr. 2016;35(4):819–825.
49. Bayat A, Azizi-Soleiman F, Heidari-Beni M, Feizi A, Iraj B, Ghiasvand R, et al. Effect of Cucurbita ficifolia and probiotic yogurt consumption on blood glucose, lipid profile, and inflammatory marker in type 2 diabetes. Int J Prev Med. 2016;7:30.
50. Hove KD, Brøns C, Færch K, Lund SS, Rossing P, Vaag A. Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study. Eur J Endocrinol. 2015;172(1):11–20.
51. Nikbakht E, Khalesi S, Singh I, Williams LT, West NP, Colson N. Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials. Eur J Nutr. 2018;57:95–106.
52. Wegh CA, Geerlings SY, Knol J, Roeselers G, Belzer C. Postbiotics and Their Potential Applications in Early Life Nutrition and Beyond. International Journal of Molecular Sciences. 2019; 20(19):4673.
53. Oleskin AV, Shenderov BA. Microbial Communication and MicrobiotaHost Interactivity: Neurophysiological, Biotechnological, and Biopolitical Implications; Nova Science Publishers: Hauppauge, NY, USA, 2020.
54. Park M, Joung M, Park JH, Keun Ha S, Park HY. Role of Postbiotics in Diet-Induced Metabolic Disorders, Nutrients. 2022;14(18):3701.
55. Tiptiri-Kourpeti A, Spyridopoulou K, Santarmaki V, Aindelis G, Tompoulidou E, Lamprianidou EE. Lactobacillus casei exerts antiproliferative effects accompanied by apoptotic cell death and up-regulation of TRAIL in colon carcinoma cells. PLoS One, 2016;11(2):e0147960.
56. Cavallari JF, Fullerton MD, Duggan B, et al. Muramyl dipeptide-based postbiotics mitigate obesity-induced insulin resistance via IRF4. Cell Metab. 2017;25: 1–12.