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Background <p>Gut microbiota modulation through probiotics or dietary fiber may offer novel strategies for improving glucose stability, yet evidence in adults with type 1 diabetes mellitus (T1DM) remains limited.</p> Objective <p>We aimed to explore the effects of probiotic and dietary fiber supplementation on glycemic variability and gut microbiota in adults with T1DM.</p> Methods <p>In this randomized controlled trial, 25 adults with T1DM were screened, and 21 eligible participants were randomized to receive either dietary fiber (<i>n</i> = 11) or probiotics (<i>n</i> = 10) for six months. Participants in the fiber group received 5&#xa0;g of dietary fiber powder twice daily after meals, while those in the probiotic group took multi-strain probiotic tablets before each meal. All participants maintained stable insulin therapy during the study. Continuous glucose monitoring (CGM) was performed before and after the intervention to assess glycemic variability (coefficient of variation, CV%) and time in range (TIR; 4.4–10.0&#xa0;mmol/L). Fecal samples were collected and analyzed using 16S rDNA sequencing to evaluate gut microbiota composition and diversity.</p> Results <p>Fiber supplementation significantly reduced glycemic variability (CV decreased from 37.4 ± 7.7% to 31.3 ± 4.6%, <i>p</i> = 0.002) and showed a trend toward improved TIR (from 54.5 ± 23.3% to 67.6 ± 21.7%, <i>p</i> = 0.058). Probiotic supplementation did not significantly affect CV (35.0 ± 5.9% to 36.6 ± 5.0%, P = 0.435) or TIR (57.5 ± 28.2% to 63.6 ± 17.3%, <i>p</i> = 0.563). Gut microbiota analysis revealed that the fiber group had a significant increase in alpha diversity and distinct shifts in beta diversity. Notably, fiber intervention enriched beneficial genera such as <i>Bifidobacterium</i> and <i>Bacteroides</i> and induced broader microbial restructuring than probiotics, as confirmed by LEfSe analysis.</p> Conclusions <p>Dietary fiber, but not probiotics, improved glycemic variability and significantly altered gut microbial composition in adults with T1DM.</p>

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Effects of probiotic and dietary fiber supplementation on glycemic variability and gut microbiota in adults with type 1 diabetes: A randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Haiyang Zhou,
  • Shiyu Wei,
  • Yanqing He,
  • Yanyan Lin,
  • Shanshan Deng,
  • Changbo Peng

摘要

Background

Gut microbiota modulation through probiotics or dietary fiber may offer novel strategies for improving glucose stability, yet evidence in adults with type 1 diabetes mellitus (T1DM) remains limited.

Objective

We aimed to explore the effects of probiotic and dietary fiber supplementation on glycemic variability and gut microbiota in adults with T1DM.

Methods

In this randomized controlled trial, 25 adults with T1DM were screened, and 21 eligible participants were randomized to receive either dietary fiber (n = 11) or probiotics (n = 10) for six months. Participants in the fiber group received 5 g of dietary fiber powder twice daily after meals, while those in the probiotic group took multi-strain probiotic tablets before each meal. All participants maintained stable insulin therapy during the study. Continuous glucose monitoring (CGM) was performed before and after the intervention to assess glycemic variability (coefficient of variation, CV%) and time in range (TIR; 4.4–10.0 mmol/L). Fecal samples were collected and analyzed using 16S rDNA sequencing to evaluate gut microbiota composition and diversity.

Results

Fiber supplementation significantly reduced glycemic variability (CV decreased from 37.4 ± 7.7% to 31.3 ± 4.6%, p = 0.002) and showed a trend toward improved TIR (from 54.5 ± 23.3% to 67.6 ± 21.7%, p = 0.058). Probiotic supplementation did not significantly affect CV (35.0 ± 5.9% to 36.6 ± 5.0%, P = 0.435) or TIR (57.5 ± 28.2% to 63.6 ± 17.3%, p = 0.563). Gut microbiota analysis revealed that the fiber group had a significant increase in alpha diversity and distinct shifts in beta diversity. Notably, fiber intervention enriched beneficial genera such as Bifidobacterium and Bacteroides and induced broader microbial restructuring than probiotics, as confirmed by LEfSe analysis.

Conclusions

Dietary fiber, but not probiotics, improved glycemic variability and significantly altered gut microbial composition in adults with T1DM.