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This randomized, double-blind clinical trial aims to evaluate the effect of a probiotic supplement on gut microbiota composition and glycemic control in adults with type 1 diabetes mellitus. A secondary comparison will be made with a healthy control group. Participants will be assigned to receive either a probiotic or a placebo for 98 days. Stool samples and metabolic parameters will be collected at baseline and after the intervention period. The study seeks to better understand how modulation of the intestinal microbiota may influence glucose regulation in people with type 1 diabetes.
This randomized, double-blind clinical trial aims to evaluate the impact of a nutritional supplement composed of inulin (prebiotic) and tyndallized probiotics (paraprobiotics) on gut microbiota composition, intestinal barrier integrity, and glycemic control in individuals with type 1 diabetes mellitus (T1D). A total of 80 participants will be recruited: 40 with T1D and 40 healthy controls. Each group will be randomly assigned to receive either the active supplement or a placebo for a period of approximately 98 days.
The study will include pre- and post-intervention assessments using stool samples (for microbiota analysis and intestinal inflammation markers like zonulin and calprotectin), continuous glucose monitor (CGM) data, blood tests (for glycemic, hepatic, renal, and lipid profiles), body composition analysis by bioimpedance (including phase angle), and validated questionnaires assessing gastrointestinal symptoms, lifestyle, dietary intake, and diabetes-related quality of life.
The main objectives are to analyze changes in gut microbiota diversity and composition, assess effects on intestinal permeability and inflammation, evaluate the safety and tolerability of the supplement, and determine its impact on metabolic markers such as fasting glucose, HbA1c, glycemic variability, and HOMA-IR.
This project seeks to explore microbiota modulation as a potential complementary therapeutic strategy for improving glycemic control and metabolic health in individuals with T1D. The supplement will be provided in 10 mL gel sticks, containing 4000 mg of inulin and 1000 mg of tyndallized probiotics, taken once daily. The intervention period has been strategically planned to avoid holidays and vacation times to ensure adherence and minimize lifestyle variability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Type 1 Diabetes - Supplement | Experimental | Participants with type 1 diabetes mellitus will receive a daily 10 mL gel supplement containing 4000 mg of inulin and 1000 mg of tyndallized probiotics for approximately 98 days. The supplement is designed to modulate gut microbiota and improve glycemic control. |
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| Type 1 Diabetes - Placebo | Experimental | Participants with type 1 diabetes mellitus will receive a daily 10 mL placebo gel without active ingredients for approximately 98 days. The placebo is organoleptically identical to the supplement to maintain blinding. |
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| Healthy Controls - Supplement | Experimental | Healthy participants will receive a daily 10 mL gel supplement containing 4000 mg of inulin and 1000 mg of tyndallized probiotics for approximately 98 days. This arm allows comparison of microbiota and metabolic responses between diabetic and non-diabetic individuals. |
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| Healthy Controls - Placebo | Experimental | Healthy participants will receive a daily 10 mL placebo gel without active ingredients for approximately 98 days. The placebo is identical in appearance and flavor to the active supplement. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Probiotic/Prebiotic Supplement | Dietary Supplement | Oral dietary supplement in gel form (10 mL per day) containing 4000 mg of inulin and 1000 mg of tyndallized probiotics. Administered once daily for approximately 98 consecutive days. Produced by Martínez Nieto S.A. (MARNYS®). Intended to modulate gut microbiota and improve glycemic and inflammatory markers. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in gut microbiota composition | Variation in the relative abundance and diversity of gut microbiota species assessed by 16S rRNA sequencing from stool samples collected at baseline and after 98 days of intervention. | Baseline and 98 days post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change in fasting glucose [Time Frame: Day 1 and Day 98] | Assessment of changes in fasting glucose levels (mg/dL) via blood test. | Baseline and 98 days post-intervention |
| Change in HbA1c [Time Frame: Day 1 and Day 98] |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| María T Mercader Ros, PhD | Contact | +349682785523 | mtmercader@ucam.edu | |
| Pablo M Barcina Pérez, PhD | Contact | +349682785523 | pbarcina@ucam.edu |
| Name | Affiliation | Role |
|---|---|---|
| María T Mercader Ros, PhD | Universidad Católica San Antonio de Murcia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCAM San Antonio Catholic University of Murcia | Murcia | Murcia | 30107 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38034007 | Background | Abuqwider J, Corrado A, Scida G, Lupoli R, Costabile G, Mauriello G, Bozzetto L. Gut microbiome and blood glucose control in type 1 diabetes: a systematic review. Front Endocrinol (Lausanne). 2023 Nov 15;14:1265696. doi: 10.3389/fendo.2023.1265696. eCollection 2023. | |
| 27100052 | Background | Stewart CJ, Nelson A, Campbell MD, Walker M, Stevenson EJ, Shaw JA, Cummings SP, West DJ. Gut microbiota of Type 1 diabetes patients with good glycaemic control and high physical fitness is similar to people without diabetes: an observational study. Diabet Med. 2017 Jan;34(1):127-134. doi: 10.1111/dme.13140. Epub 2016 May 14. |
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| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D019936 | Probiotics |
| ID | Term |
|---|---|
| D019587 | Dietary Supplements |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
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This is a 2x2 factorial, randomized, double-blind clinical trial including adults with type 1 diabetes and healthy controls. Participants in both groups will be randomly assigned to receive either a probiotic/prebiotic supplement or a placebo. The intervention period will last approximately 98 days. The design allows for the evaluation of the independent and combined effects of participant type (T1D vs. healthy) and intervention (supplement vs. placebo).
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This is a double-blind study. Participants, investigators, care providers, and outcomes assessors are unaware of the group assignments. The probiotic and placebo supplements are identical in appearance and packaging, and group codes will remain confidential until after data analysis is complete.
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| Placebo Gel | Dietary Supplement | Oral placebo in gel form (10 mL per day), identical in appearance, texture, and taste to the active supplement, but without probiotic or prebiotic components. Administered once daily for 98 days to maintain blinding and control effects. |
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Assessment of changes in glycated hemoglobin levels (HbA1c, %) via blood test.
| Baseline and 98 days post-intervention |
| Change in fasting insulin [Time Frame: Day 1 and Day 98] | Assessment of changes in fasting insulin levels via blood test. μU/mL | Baseline and 98 days post-intervention |
| Change in HOMA-IR index [Time Frame: Day 1 and Day 98] | Assessment of changes in insulin resistance estimated using the HOMA-IR index. | Baseline and 98 days post-intervention |
| Change in time in range (70-180 mg/dL) [Time Frame: 3 months] | Assessment of the percentage of time that glucose levels are within the target range using continuous glucose monitoring (CGM). | Baseline and 98 days post-intervention |
| Change in time above range (>180 mg/dL) [Time Frame: 3 months] | Assessment of the percentage of time with hyperglycemia using CGM. | Baseline and 98 days post-intervention |
| Change in time below range (<70 mg/dL) [Time Frame: 3 months] | Assessment of the percentage of time with hypoglycemia using CGM. | Baseline and 98 days post-intervention |
| Change in mean glucose [Time Frame: 3 months] | Assessment of average glucose concentration (mg/dL) using CGM. | Baseline and 98 days post-intervention |
| Change in glucose variability [Time Frame: 3 months] | Assessment of glucose coefficient of variation (%) using CGM. | Baseline and 98 days post-intervention |
| Change in plasma zonulin levels [Time Frame: Day 1 and Day 98] | Zonulin levels will be measured in fasting plasma samples using ELISA at baseline and after the intervention (ng/mL). | Baseline and 98 days post-intervention |
| Change in fecal calprotectin levels [Time Frame: Day 1 and Day 98] | Calprotectin levels will be measured in stool samples using immunoassay at baseline and after the intervention (µg/g). | Baseline and 98 days post-intervention |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D019602 |
| Food and Beverages |