Short-Chain Fructooligosaccharides Improve Gut Microbiota Composition in Patients with Type 2 Diabetes. A randomized, Open-Label, Controlled Pilot Clinical Trial

Abstract

In this study, the impact of KestoMix, a syrup containing short-chain fructooligosaccharides (scFOS) mainly 1-kestose, on clinical parameters and gut microbiota composition in type 2 diabetes (T2DM) patients was investigated. The study was conducted as a randomized, open label, controlled clinical trial involving 60 participants. The control group consumed microcrystalline cellulose capsules, while the KestoMix group consumed KestoMix (7.2 g) twice a day for 12 weeks. Stool and blood samples were collected from all the subjects. The gut microbial composition in feces was analyzed for 20 subjects by next-generation sequencing of the V3–V4 region of the bacterial 16S rRNA gene. KestoMix did not significantly modify the basal clinical parameters associated with T2DM, but it significantly reduced serum LDL-c concentration at week 12. In terms of gut microbial composition, the presence of Firmicutes was higher than Bacteroidetes in both groups, but KestoMix intake resulted in a reduction in the Firmicutes/Bacteroidetes ratio. Also, a significant increase (p=0.046) in the Bacteroidetes/Proteobacteria ratio compared to the control group was observed at day 84. Furthermore, KestoMix intake significantly stimulated the increase in Bifidobacterium, as well as Blautia and Lactobacillus (p=0.007, p=0.034 and p=0.016, respectively). While the alpha diversity of gut microbial composition was reduced after KestoMix intake, there was a change in the existing taxonomic proportions. Overall, this study highlights the positive impact of KestoMix on gut microbiota in T2DM patients. The bifidogenic effect of KestoMix may provide long-term benefits in complications associated with T2DM and other dysbiosis.