Synbiotics may benefit women with gestational diabetes

A combination of three probiotic strains and prebiotic inulin may improve markers of insulin metabolism and lipid levels in women with gestational diabetes, says a new study.

Data published in the British Journal of Nutrition indicated that the combination of Lactobacillus acidophilus, L. casei and Bifidobacterium bifidum plus inulin for six weeks was associated with improvements in insulin metabolism and levels of VLDL-cholesterol and triglycerides.

“This suggests that synbiotic supplementation may confer advantageous therapeutic potential for patients with gestational diabetes mellitus (GDM),” wrote the researchers. “Further research is needed in other patients and for longer periods to determine the safety of this supplemental approach. In addition, further studies are needed to evaluate the expressed levels of related variables with insulin resistance and lipid profiles to explore the plausible mechanism and confirm our findings.”

Gestational diabetes

According to the Centers for Disease Control and Prevention, gestational diabetes is defined as “impaired glucose tolerance with onset or first recognition during pregnancy”. A 2014 CDC analysis reported that the prevalence could be as high as 9%.

The double-blind, placebo-controlled study involved 70 women with GDM randomly assigned to receive supplements containing L. acidophilus, L. casei and B. bifidum (at a dosage of 2 billion colony-forming units per gram each) combined with 800 mg inulin or placebo for six weeks.

Results showed that synbiotic supplementation led to significant decreases in insulin levels, compared to placebo. Insulin resistance, measured using the homeostatic model assessment (HOMA-IR), also decreased in the synbiotic group, but increased in the placebo group.

In addition, insulin sensitivity, measured using the quantitative insulin-sensitivity check index (QUICKI), improved in the synbiotic group, but not in the placebo group.

Blood lipids, including triglycerides and VLDL-cholesterol, decreased in the synbiotic group, but increased in the placebo group.

“Although the beneficial effects of synbiotic intake on markers of insulin resistance on patients without GDM and animal models have been evaluated, to the best of our knowledge, this study is the first to assess the favorable effects of synbiotic supplementation on markers of insulin resistance in patients with GDM,” wrote the researchers.

“Synbiotic intake might improve glucose homoeostasis parameters through modification of gut flora, reduction of endotoxin levels, reduction of production and absorption of intestinal toxins, elevation of fecal pH and reduction of pro-inflammatory cytokine production.”

Source: British Journal of Nutrition

Published online ahead of print, doi: 10.1017/S0007114516003457

“The effects of synbiotic supplementation on markers of insulin metabolism and lipid profiles in gestational diabetes: a randomised, double-blind, placebo-controlled trial”

Authors: S. Ahmadi et al.