Probiotics and Diabetes

Bowls of cheese, yogurt, tempeh, and milk

Written by Emily, and originally published by T1D Exchange in September, 2022. Check out T1D Exchange’s website for more great T1D info.

The health world is buzzing about probiotics–and for potentially good reasons! Researchers are learning more and more about the human microbiome–the unique collection of bacteria and microorganisms that live in the body–and how the microbiome can affect an individual’s health. Probiotics play a big role in the gut microbiome and are a common treatment for certain digestion problems.

Newer research is looking at how the microbiome impacts other areas of the body, such as heart and mental health–but what about diabetes? This article will discuss what probiotics are, food sources, their potential health benefits related to diabetes, and how to support a healthy gut microbiome.

What are Probiotics?

Probiotics are the “good” bacteria and yeasts that naturally live in the human body. There are many types of probiotics with different functions – some help digest food, others fight off infection and inflammation, and some even make vitamins. Not having enough probiotics in your microbiome can throw the body off balance.

Common types of probiotics found in foods and supplements are Lactobacillus and Bifidobacterium, and within these types there are hundreds of different species that play many different roles in the body.

Probiotic Food Sources

Probiotics are found in many fermented foods. Adding these foods to your diet may enhance your gut microbiome:

  • Yogurts that contain “live active cultures”
  • Kombucha (fermented tea)
  • Sauerkraut (fermented cabbage)
  • Kimchi (Korean fermented vegetables)
  • Miso (Japanese fermented soybeans)
  • Buttermilk
  • Kefir (fermented milk)
  • Cheeses (brie, gruyere, Swiss, provolone, Gouda, feta, cottage cheese, cheddar)
  • Tempeh (fermented soybeans)

Prebiotics

Prebiotics are the preferred food source of probiotics, and include fiber and complex carbohydrates. Since probiotics are living organisms like us, they need to eat! Focusing on eating high-fiber foods like fruits, vegetables, and whole grains regularly can help keep the probiotics in your gut happy. Foods that are particularly rich in prebiotics are things like:

  • Garlic
  • Bananas
  • Whole grains (e.g., corn, oats, wheat bran, farro, barley)
  • Onions
  • Asparagus
  • Cocoa powder
  • Chicory root
  • Flaxseeds
  • Seaweed

Health Benefits of Probiotics

Probiotics seem to have a positive impact on certain digestive problems, but research is still in the early stages for many other health conditions, including diabetes. Here’s what researchers have found so far…

Probiotics and Diabetes

Some research shows that certain probiotics from foods and supplements can help people with type 2 diabetes (T2D) reduce fasting blood glucose and HbA1c, especially in those not on insulin therapy.

Gestational diabetes research has found similar effects in response to probiotic supplementation, as well as decreased insulin resistance.

However, fewer studies have explored the impact of probiotics on glucose levels in type 1 diabetes (T1D). It is suspected that an imbalanced microbiome may contribute to the onset of T1D for some, and research is currently underway on health outcomes from probiotic supplementation shortly after T1D diagnosis. A small T1D study published in 2022 found that children who took probiotic supplements for 3 months reduced their fasting glucose by ~23mg/dL and HbA1c by 0.8%.

Unfortunately, probiotic research in adults with T1D is lacking. However, probiotics may be beneficial when it comes to certain diabetes-related health problems, such as heart disease, periodontal disease, and gastroparesis.

Probiotics and Heart Health

People with diabetes are at increased risk for heart disease. Some research shows that probiotics can have positive effects on heart health by lowering total and LDL (or “bad”) cholesterol levels.

According to the National Institutes of Health, certain probiotics found in foods and supplements may help lower total and LDL cholesterol levels:

Talk to your healthcare team about probiotics for heart health, as research is constantly evolving, and everyone has unique health needs.

Probiotics and Periodontal Disease

Periodontal (gum) disease is more prevalent among people with diabetes. Early studies suggest that probiotics can help manage periodontal disease by correcting the imbalance of “bad” bacteria in the mouth and reducing gum inflammation.

Probiotics and Gastroparesis

Gastroparesis is a complication of diabetes that seems to be more common in those with T1D. It slows digestion down and can cause uncomfortable symptoms like bloating and indigestion.

While there is limited research on the effects of probiotics on gastroparesis, the International Foundation for Functional Gastrointestinal Disorders suggests probiotics may be helpful in managing symptoms of gastroparesis.

How to Support a Healthy Microbiome

The microbiome’s impact on overall health is an exciting new field with promising research. While there is still more to learn, especially about the microbiome and diabetes, we do know that a healthy diet can support a healthy microbiome.

Here are a few ways you do that:

Eat a variety of foods that are rich in fiber (prebiotics), such as fruits, vegetables, whole grains, nuts, seeds, and beans

Eat fermented foods when you can, like low-sugar yogurt

Probiotic + Prebiotics Sample Menu

Breakfast: yogurt, banana, ground flaxseed

Lunch: sourdough bread sandwich with Swiss cheese, tomatoes, and onions; Kombucha

Dinner: grilled chicken, barley, and asparagus cooked with garlic

Snack: whole grain pita with hummus and carrots

Supplements

Probiotic and prebiotic nutrition supplements are available in many forms (e.g., capsules, powders), but unfortunately they aren’t government regulated and can be costly. Additionally, probiotic potency in supplement form can degrade over time.

Healthline offers a great article about different types of probiotic supplements and their intended use. As always, consult your healthcare team before starting a nutrition supplement.

Summary

While definitive research on probiotics and T1D is lacking, a healthy microbiome may improve your overall health. Probiotics are part of a healthy microbiome, and can be found in many fermented foods.

Additionally, probiotics may help improve some diabetes-related health conditions. For most people, the risks from eating probiotics and prebiotics through food sources is low, and a diet rich in fruits, vegetables, and whole grains can enhance your microbiome.

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