اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

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کد مقاله 1058

عنوان Microbiome-mediated metabolic rehabilitation: The role of prebiotics and probiotics in improving insulin resistance and preventing diabetic osteoporosis

نویسندگان Azadehalsadat Hosseini dastgerdi

چکیده Introduction: Type 2 diabetes mellitus (T2DM) is associated with two major challenges: 1. Insulin resistance (the axis of metabolic dysfunction), 2. Diabetic osteoporosis (a silent but debilitating complication). One of the new targets proposed for metabolic rehabilitation is the “microbiome-gut-bone” axis. However, there is a deep gap between the evidence related to the effect of probiotics/prebiotics on blood sugar and their effect on bone health. Method: This review study critically compares the available clinical evidence in the two areas of “microbiome-insulin” and “microbiome-diabetic bone”. Findings: Regarding insulin resistance, relatively strong clinical evidence supports the efficacy of Acremantia musciniphila and inulin-like fructo-oligosaccharides, although contradictory results and conflicts of interest are evident in some studies. On the other hand, regarding diabetic osteoporosis, some studies, including a clinical trial (Birkland et al., 2025, University of Oslo), showed no significant effect on calcium, magnesium, vitamin D, P1NP, and CTX-1 with a 6-week course of inulin supplementation. This contradiction indicates a deep gap in the understanding of the effect of probiotics on insulin resistance and osteoporosis. Conclusion: Microbiome therapy in metabolic rehabilitation of diabetes is recommended for glucose control and inflammation, but its prescription for the prevention or treatment of diabetic osteoporosis lacks clinical evidence and is considered a “premature leap from animal evidence to clinical recommendation”. Clinical trial designs with an intervention period of ≥12 weeks, selection of populations with confirmed osteopenia/osteoporosis, and use of synbiotic combinations are essential.

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