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Diabetes and Vascular Disease

SAT-548 - Probiotics and Insulin Sensitivity in Adults with Obesity or Prediabetes: A Systematic Review and Meta-Analysis

Saturday, June 13, 2026
9:30 AM - 4:30 PM CT


Introduction:  Obesity and prediabetes are associated with chronic low grade systemic inflammation and insulin resistance, partly driven by gut derived metabolic endotoxemia. Dysbiosis impairs epithelial barrier integrity, facilitating endotoxin translocation and exacerbating metabolic dysfunction. Although probiotics have been proposed as a therapeutic strategy to modulate gut microbiota and improve insulin signaling pathways, current human evidence remains inconsistent. Therefore, a rigorous quantitative synthesis is needed to clarify the true impact of probiotic supplementation on insulin sensitivity in adults with obesity or prediabetes.

Objective:  To perform a systematic review and meta analysis of randomized controlled trials (RCTs) to evaluate the effect of probiotic supplementation on insulin sensitivity in adults with obesity or prediabetes.

Methods:  This systematic review and meta analysis was conducted according to PRISMA guidelines. Literature searches were conducted in PubMed, Embase, and the Cochrane Library. 35 full text articles were assessed, 10 RCTs were included in the quantitative synthesis. Heterogeneity was evaluated using the I² statistic, and pooled estimates were calculated using a random effects model.

Results:  Probiotic supplementation, alone or combined with functional foods, was associated with significant improvements in insulin related parameters. A statistically significant reduction in fasting insulin levels and HOMA IR was observed. Subgroup analyses indicated greater benefits with multispecies formulations and higher doses. Results for fasting glucose were heterogeneous, with no consistent overall effect across studies. Anthropometric outcomes, including BMI and waist circumference, showed reductions in the intervention group, although without consistent statistical superiority over placebo. Additionally, mechanisms involving increased incretin secretion (e.g., GLP-1) suggest a potential adjunct metabolic effect on satiety. Observed heterogeneity was attributed to variations in strains, dosages, intervention duration, and population characteristics.

Conclusion:  This study demonstrates that probiotic supplementation is associated with improved insulin sensitivity in adults with obesity or prediabetes, particularly through reductions in HOMA IR and fasting insulin. These findings support the potential role of probiotics as an adjunct strategy in metabolic management. However, the variability of results indicates that effects are not uniform and are influenced by strain specificity and colony forming unit dosage. Further well designed trials are required to establish standardized clinical protocols.

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