Effects of probiotic supplementation on glycemic control in children with type 1 diabetes: A systematic review and meta-analysis.

BackgroundThis study aimed to evaluate the effects of probiotic supplementation on glycemic control in children with type 1 diabetes, as measured using glycated hemoglobin level, fasting blood glucose level, and insulin requirements.MethodsA systematic search was conducted across four databases (PubMed, Web of Science, Embase, and Scopus) to identify eligible randomized controlled trials. The Cochrane Risk of Bias tool was used to assess methodological quality. Meta‑analyses were performed using random‑effects models, with subgroup analysis conducted by probiotic strain. The study was registered with the Research Registry (reviewregistry2089).ResultsSix randomized controlled trials (483 children) were included. Probiotic supplementation significantly reduced glycated hemoglobin levels (weighted mean difference: -0.54%; 95% confidence interval: -0.90% to -0.18%; p = 0.003; I2 = 19.65%) and insulin requirements (weighted mean difference: -0.082 U/kg/day; 95% confidence interval: -0.147 to -0.017; p = 0.013; I2 = 0%). Fasting blood glucose levels showed a non‑significant reduction (mean difference: -10.54 mg/dL; 95% confidence interval: -23.25 to 2.17; p = 0.104; I2 = 0%). Subgroup analysis revealed that the De Simone formulation explained 70.32% of the between‑study variance. No publication bias was detected.ConclusionProbiotic supplementation, particularly specific formulations, may reduce glycated hemoglobin levels and insulin needs in children with type 1 diabetes, supporting probiotics supplementation as an adjunctive therapy; however, larger trials are needed to confirm these findings.