Gut microbiota-modulating interventions in paediatric type 1 diabetes: systematic review and meta-analysis
Oral probiotics, prebiotics, and synbiotics reduced HbA1c and fasting blood glucose in children with T1D, with no significant effect on daily insulin dose or C-peptide.
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What the study showed
A meta-analysis of 12 RCTs (808 paediatric participants) showed significant reductions in HbA1c and fasting blood glucose following oral microbiota-modulating interventions. Total daily insulin dose and C-peptide showed no significant pooled effect. Immune-inflammatory, microbiota-related, and intestinal permeability outcomes suggested possible benefits, but quantitative pooling was not feasible due to inconsistent reporting.
How it was done
Systematic review and meta-analysis conducted per PRISMA 2020, searching PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL from inception to February 2026, including only RCTs of oral probiotics, prebiotics, or synbiotics in participants aged ≤19 years with T1D.
Risk of bias
Substantial clinical and methodological heterogeneity across studies, variation in formulation, dose, and duration, and inconsistent secondary outcome reporting preclude robust conclusions. Access limited to the abstract prevents individual risk-of-bias assessment and evaluation of effect sizes.
What this study does NOT prove
It cannot be concluded that microbiota interventions preserve beta-cell function, reduce insulin requirements, or modify the course of autoimmune disease.
In clinical practice
Findings do not support routine clinical recommendation. Current evidence is insufficient to guide prescription of microbiota-modulating agents in children with T1D.
Limitations
Substantial clinical and methodological heterogeneity across studies, variation in formulation, dose, and duration, and inconsistent secondary outcome reporting preclude robust conclusions. Access limited to the abstract prevents individual risk-of-bias assessment and evaluation of effect sizes.
Technical appendix
Version history
- 1.0 · 2026-06-25 — Auto-generated under Evidence Standard v1.0
Paid access: structured summary from public metadata; consult the original study at the source.