In the Journals

Prebiotic supplement increases C-peptide levels in children with type 1 diabetes

Children with type 1 diabetes assigned to a daily prebiotic powder supplement for 3 months experienced a “significant preservation” in C-peptide levels compared with children assigned to placebo, as well as increased intestinal permeability, according to findings from a small randomized controlled trial.

Carol Huang

“Prebiotics may be beneficial in children with type 1 diabetes by altering their intestinal microbiome,” Carol Huang, MD, PhD, FRCPC, associate professor in the department of pediatrics and biochemistry and molecular biology at the University of Calgary and head of the division of endocrinology at Alberta Children’s Hospital Health Science Centre, told Endocrine Today. “A healthier intestinal microbiome may translate into better metabolic control and, hopefully, fewer long-term complications in children with type 1 diabetes.”

Huang and colleagues analyzed data from 38 children aged 8 to 17 years with type 1 diabetes for at least 1 year, recruited from a tertiary care center from February 2016 to March 2017 (mean age, 12 years; mean HbA1c, 8%). Researchers randomly assigned participants to a prebiotic of 8 g oligofructose-enriched inulin per day (chicory-root derived Orafti Synergy1, Beneo; n = 17) or 3.3 g maltodextrin per day (placebo; n = 20), both provided in powder form to be mixed into water. The 3-month intervention was followed by a 3-month washout period. At baseline and 3 months, researchers measured serum C-peptide, HbA1c and serum inflammatory markers. Intestinal permeability via stool samples was assessed at baseline, 3 and 6 months

At 3 months, C-peptide levels were higher in the prebiotic group (P = .029) as was intestinal permeability (P = .076). There were no between-group differences in HbA1c or inflammatory markers at 3 months.

“Due to the known effect of prebiotic-associated bacterial metabolites on stimulation of glucagon-like peptides, we measured serum levels of GLP-1 and GLP-2 before and after the prebiotic treatment,” the researchers wrote. “Here, we observed no significant difference in GLP-1 and GLP-2 in response to the treatment between the placebo and prebiotic group.”

Researchers observed an increase in the relative abundance of Bifidobacterium within the prebiotic group at 3 months, which was no longer present after the 3-month washout period. The placebo group had significantly higher relative abundance of Streptococcus, Roseburia inulinivorans, Terrisporobacter and Faecalitalea vs. the prebiotic group at 3 months, the researchers wrote.

In assessing gut microbiota, researchers found that within-sample diversity was “slightly but significantly decreased” in the prebiotic group (P = .035), whereas permutational multivariate analysis of variance showed a significant effect of treatment on the overall microbial community structure in the prebiotic group (P = .003).

“Confirmation of our findings in a larger, multicenter study is needed to validate our finding in this study,” Huang said. – by Regina Schaffer

For more information:

Carol Huang, MD, PhD, FRCPC, can be reached at Alberta Children’s Hospital Health Science Centre, 3330 Hospital Drive NW, Room 2219, Calgary, AB, Canada; email: carol.huang@ahs.ca.

Disclosure: One of the study authors reports she has received honoraria from Beneo.

Children with type 1 diabetes assigned to a daily prebiotic powder supplement for 3 months experienced a “significant preservation” in C-peptide levels compared with children assigned to placebo, as well as increased intestinal permeability, according to findings from a small randomized controlled trial.

Carol Huang

“Prebiotics may be beneficial in children with type 1 diabetes by altering their intestinal microbiome,” Carol Huang, MD, PhD, FRCPC, associate professor in the department of pediatrics and biochemistry and molecular biology at the University of Calgary and head of the division of endocrinology at Alberta Children’s Hospital Health Science Centre, told Endocrine Today. “A healthier intestinal microbiome may translate into better metabolic control and, hopefully, fewer long-term complications in children with type 1 diabetes.”

Huang and colleagues analyzed data from 38 children aged 8 to 17 years with type 1 diabetes for at least 1 year, recruited from a tertiary care center from February 2016 to March 2017 (mean age, 12 years; mean HbA1c, 8%). Researchers randomly assigned participants to a prebiotic of 8 g oligofructose-enriched inulin per day (chicory-root derived Orafti Synergy1, Beneo; n = 17) or 3.3 g maltodextrin per day (placebo; n = 20), both provided in powder form to be mixed into water. The 3-month intervention was followed by a 3-month washout period. At baseline and 3 months, researchers measured serum C-peptide, HbA1c and serum inflammatory markers. Intestinal permeability via stool samples was assessed at baseline, 3 and 6 months

At 3 months, C-peptide levels were higher in the prebiotic group (P = .029) as was intestinal permeability (P = .076). There were no between-group differences in HbA1c or inflammatory markers at 3 months.

“Due to the known effect of prebiotic-associated bacterial metabolites on stimulation of glucagon-like peptides, we measured serum levels of GLP-1 and GLP-2 before and after the prebiotic treatment,” the researchers wrote. “Here, we observed no significant difference in GLP-1 and GLP-2 in response to the treatment between the placebo and prebiotic group.”

Researchers observed an increase in the relative abundance of Bifidobacterium within the prebiotic group at 3 months, which was no longer present after the 3-month washout period. The placebo group had significantly higher relative abundance of Streptococcus, Roseburia inulinivorans, Terrisporobacter and Faecalitalea vs. the prebiotic group at 3 months, the researchers wrote.

In assessing gut microbiota, researchers found that within-sample diversity was “slightly but significantly decreased” in the prebiotic group (P = .035), whereas permutational multivariate analysis of variance showed a significant effect of treatment on the overall microbial community structure in the prebiotic group (P = .003).

“Confirmation of our findings in a larger, multicenter study is needed to validate our finding in this study,” Huang said. – by Regina Schaffer

For more information:

Carol Huang, MD, PhD, FRCPC, can be reached at Alberta Children’s Hospital Health Science Centre, 3330 Hospital Drive NW, Room 2219, Calgary, AB, Canada; email: carol.huang@ahs.ca.

Disclosure: One of the study authors reports she has received honoraria from Beneo.