title: Metabolic effects of Lactobacillus reuteri DSM 17938 in people with type 2 diabetes: A randomized controlled trial.
abstract: To investigate the metabolic effects of 12-week oral supplementation with Lactobacillus reuteri DSM 17938 in patients with type 2 diabetes on insulin therapy.
  
  
  
  In a double-blind trial, we randomized 46 people with type 2 diabetes to placebo or a low (108CFU/d) or high dose (1010CFU/d) of L. reuteri DSM 17938 for 12 weeks. The primary endpoint was the effect of supplementation on glycated haemoglobin (HbA1c). Secondary endpoints were insulin sensitivity (assessed by glucose clamp), liver fat content, body composition, body fat distribution, faecal microbiota composition and serum bile acids.
  
  
  
  Supplementation with L. reuteri DSM 17938 for 12 weeks did not affect HbA1c, liver steatosis, adiposity or microbiota composition. Participants who received the highest dose of L. reuteri exhibited increases in insulin sensitivity index (ISI) and serum levels of the secondary bile acid deoxycholic acid (DCA) compared with baseline, but these differences were not significant in the between-group analyses. Post hoc analysis showed that participants who responded with increased ISI after L. reuteri supplementation had higher microbial diversity at baseline, and increased serum levels of DCA after supplementation. In addition, increases in DCA levels correlated with improvement in insulin sensitivity in the probiotic recipients.
  
  
  
  Intake of L. reuteri DSM 17938 for 12 weeks did not affect HbA1c in people with type 2 diabetes on insulin therapy; however, L. reuteri improved insulin sensitivity in a subset of participants and we propose that high diversity of the gut microbiota at baseline may be important.
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Reza
authors.initials: R
authors.lastname: Mobini
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Valentina
authors.initials: V
authors.lastname: Tremaroli
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ståhlman
authors.affiliation: Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Karlsson
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Levin
authors.affiliation: Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Ljungberg
authors.affiliation: Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Maja
authors.initials: M
authors.lastname: Sohlin
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Heléne
authors.initials: H
authors.lastname: Bertéus Forslund
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Rosie
authors.initials: R
authors.lastname: Perkins
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.|Novo Nordisk Foundation Centre for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Bäckhed
authors.affiliation: Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Per-Anders
authors.identifier: 0000-0003-4032-3317
authors.initials: PA
authors.lastname: Jansson
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003840:Deoxycholic Acid / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000382:microbiology / Q000628:therapy*; D019587:Dietary Supplements / Q000382:microbiology*; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D015309:Glucose Clamp Technique; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007333:Insulin Resistance; D052200:Limosilactobacillus reuteri / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage*
chemical_list: D001786:Blood Glucose; D003840:Deoxycholic Acid; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: 
  
  Lactobacillus reuteri DSM 17938; bile acids; gut microbiota; insulin sensitivity; probiotic supplementation; type 2 diabetes