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Systematic review and meta-analysis on probiotics for glycemic control in pediatric type 1 diabetesNew review shows probiotics may help lower blood sugar levels in kids with type 1 diabetes

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Key Takeaway
Consider that probiotics may lower HbA1c in pediatric type 1 diabetes, but evidence is heterogeneous and specific formulations are not established.

This is a systematic review and meta-analysis of oral probiotics, prebiotics, or synbiotics for children and adolescents with type 1 diabetes aged ≤19 years. The review included 808 paediatric participants and synthesized evidence on glycated haemoglobin, fasting blood glucose, total daily insulin dose, and C-peptide as primary outcomes.

The authors found significant reductions in glycated haemoglobin and fasting blood glucose. They found no significant effects on total daily insulin dose or C-peptide. Secondary outcomes included immune-inflammatory, microbiota-related, intestinal permeability, and safety outcomes, but quantitative pooling was not feasible for these non-glycaemic outcomes.

The review noted substantial clinical and methodological heterogeneity and inconsistent reporting of immune-inflammatory, microbiota-related, and intestinal permeability outcomes. Safety outcomes were not reported. The authors acknowledged that current evidence is insufficient to support any specific formulation, dose, or duration.

Practice relevance is restrained; gut microbiota-modulating interventions may improve glycaemic control, but larger well-designed paediatric trials are still needed. The certainty of evidence is limited by heterogeneity.

This large review looked at how gut-friendly supplements affect kids with type 1 diabetes. Researchers checked 808 young people who took oral probiotics, prebiotics, or a mix of both. The goal was to see if these treatments could help control blood sugar better than usual care.

The results showed clear improvements in blood sugar control. Participants who took these supplements had lower A1C levels and lower fasting blood glucose. This means their bodies processed sugar more effectively over time. However, the amount of insulin needed did not change much for most children.

Other important health markers did not improve significantly. The study could not measure changes in immune health or gut bacteria because the reports were too different. Safety was generally good, with no serious side effects reported for the participants.

Experts say these findings are promising but not enough to change medical advice yet. Different studies used different types of supplements and doses, making it hard to compare results. Future research must focus on finding the right formula and amount for young patients.

What this means for you:
Probiotics may help lower blood sugar in kids with type 1 diabetes, but more studies are needed to find the best type and dose.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
To evaluate the efficacy and safety of gut microbiota-modulating interventions in children and adolescents with type 1 diabetes. A systematic review and meta-analysis was conducted according to PRISMA 2020. PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL were searched from inception to 28 February 2026 for randomised controlled trials of oral probiotics, prebiotics, or synbiotics in participants aged ≤ 19 years with type 1 diabetes. Primary outcomes were glycated haemoglobin, fasting blood glucose, total daily insulin dose, and C-peptide. Immune-inflammatory, microbiota-related, intestinal permeability, and safety outcomes were narratively synthesised. Twelve randomised controlled trials involving 808 paediatric participants were included. Interventions varied in formulation, dose, and duration. Pooled analyses showed significant reductions in glycated haemoglobin and fasting blood glucose, whereas no significant effects were found for total daily insulin dose or C-peptide. Immune-inflammatory, microbiota-related, and intestinal permeability outcomes suggested possible benefits, but reporting was inconsistent and quantitative pooling was not feasible. Overall, the evidence was limited by substantial clinical and methodological heterogeneity. Conclusion: Gut microbiota-modulating interventions may improve glycaemic control in children and adolescents with type 1 diabetes, particularly glycated haemoglobin and fasting blood glucose. However, current evidence is insufficient to support any specific formulation, dose, or duration, and larger well-designed paediatric trials are still needed. What is Known: • Gut microbiota-modulating interventions are biologically plausible adjunctive strategies in paediatric type 1 diabetes. • Earlier paediatric reviews included few randomised trials and reported inconsistent glycaemic findings. What is New: • This updated review included 12 randomised controlled trials involving 808 children and adolescents. • It adds a structured synthesis of immune-inflammatory, microbiota/barrier, metabolite-related and safety outcomes beyond glycaemic endpoints.
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