What is the role of probiotic supplementation in the treatment of pediatric type 1 diabetes mellitus (DM)?

Updated: Mar 23, 2021
  • Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD  more...
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Data from the multinational Environmental Determinants of Diabetes in the Young (TEDDY) study suggest that probiotic supplementation before the age of 3 months in infants with type 1 diabetes (DM1)–associated HLA-DR-DQ alleles is linked to a reduction in the risk of developing pancreatic beta-cell islet autoimmunity as compared with infants older than 3 months who received probiotics or those not given any probiotics (hazard ratio [HR], 0.62; 95% confidence interval, 0.45-0.84; P =0.0018). [52, 53]  The association was particularly strong in infants younger than 1 month who received probiotic supplementation relative to those given probiotics when older than 12 months or not at all (HR, 0.63; P =0.022). [53]

Results from 7468 infants in the ongoing prospective birth-cohort study varied across countries: Of 575 infants (7.7%) with islet-cell autoimmunity, 9.1% were from Germany, 8.7% from Finland, 8.6% from Sweden, and 6.3% from the United States. [53]  Testing included detection of the islet autoantibodies GADA, IAA, or IA-2A at two consecutive visits. [52, 53]  The HR ratios for the link between early probiotic use and islet-cell autoimmunity were 0.65 (P =0.37) for Germany, 0.72 (P =0.10) for Finland, 0.42 (P =0.0165) for Sweden, and 0.62 (P =0.50) for the United States. [52]

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