Molly Knudsen, M.S., RDN is a Registered Dietician Nutritionist with a bachelor’s degree in nutrition from Texas Christian University and a master’s in nutrition interventions, communication, and behavior change from Tufts University. She lives in Newport Beach, California, and enjoys connecting people to the food they eat and how it influences health and wellbeing.
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April 24, 2025
Only 12% of adults in the U.S. are considered to be metabolically healthy. And targeting the gut microbiome is an underrated—yet science-backed—way to significantly improve blood sugar balance.
There are a lot of eyes on probiotics as being a potential game changer for diabetes management (or for those wanting extra blood sugar support).
Researchers of a new study published in Clinical Nutrition specifically looked at how supplementing with probiotics or synbiotics (a combo of probiotics and prebiotic fibers) impacts blood sugar control of people with diabetes. Here's what they found.
About the study
Researchers analyzed and pooled data from 41 randomized controlled trials (a total of almost 3,000 individuals with Type 1 or 2 diabetes) that all specifically looked at eitherprobiotic or synbiotic use on blood sugar outcomes—like hemoglobin A1c (HbA1c), fasting glucose, and blood insulin levels.
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Now remember, probiotics are live microorganisms (usually bacteria or yeasts) you ingest that have a positive impact on health. There are thousands of different probiotic strains out there that all have slightly different effects on the gut.
Prebiotics, on the other hand, are fibers that nourish only the good bacteria residing in the gut. Synbiotics are a combination of both pre- and probiotics.
The idea behind synbiotics is that by providing both the live organisms and the nutrients they need to flourish, you can potentially achieve a greater impact on the gut than using either one alone.
No probiotic or synbiotic combinations were the same across the 41 trials included in this larger analysis.
Probiotics & synbiotics were linked to better blood sugar levels
Overall, results showed that there were significant improvements in all three measures of blood sugar control after about 12 weeks of supplementation, with HbA1c being the most pronounced.
And that makes sense. HbA1c represents average blood sugar levels1 over the last two to three months (and is expressed as a percent).
As a probiotic or synbiotic was the main change participants made in three months, it's a promising sign to see this important marker of metabolic health starting to trend down.
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Fasting glucose and insulin levels also improved for this group (but there was more variability). Glucose and insulin levels are acute measures of your current blood sugar status and could be impacted by non-related factors like stress or sleeping poorly.
The gut's role in metabolic health
There are a few ways in which probiotics and fiber (and improving gut health in general) are tied to better blood sugar control:
Restoring balance to the gut: Research shows that people with diabetes also have dysbiosis of the gut (an imbalance of good to bad bacteria). Gut dysbiosis can contribute to low-grade inflammation and worsened insulin sensitivity2. Probiotics may help correct some of that imbalance by providing beneficial microbes to the gut, while prebiotics help the good bacteria that are already there thriving.
Slowing the absorption of glucose to the bloodstream: Prebiotics are fiber and help stabilize blood sugar levels after eating by slowing the digestion of carbs and preventing blood sugar levels from spiking too high.
Reducing inflammation: Probiotics may provide some anti-inflammatory properties3 to the gut, which can help mitigate (and alleviate) metabolic disorders associated with chronic inflammation and oxidative stress—including diabetes4.
Choosing the right probiotics and synbiotics
This study was only able to conclude that probiotics and synbiotics are good for blood sugar control—especially multi-strain probiotics. However, the study wasn't designed to give more granular recommendations like the specific strains/fiber and the best dose of each ingredient.
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That being said, probiotic supplements are truly a dime a dozen. But many fail to list the specific strains and the specific dose of each on the bottle (and that's a major red flag).
Prebiotic fiber supplements are also becoming increasingly popular—as people realize they not only improve blood sugar but also keep your bowel movement regular, your appetite satisfied, and your weight more manageable.
Managing and preventing metabolic conditions (including Type 2 diabetes) is more important than ever.
While diet and exercise play an outsized role in blood sugar control, additional therapies, including ones that support gut health, are effective and typically easy for folks to incorporate into their daily routines.
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