Potential role of Limosilactobacillus fermentum as a probiotic with anti-diabetic properties: A review

Table 2 Primary outcomes of the studies testing the anti-diabetic effect of Limosilactobacillus fermentum strains

Ref.	Primary end-points
Hartajanie et al[50], 2020	↓ The fasting blood glucose; ↓ Postprandial blood glucose; ↑ In SOD concentrations
Hu et al[35], 2019	↓ Blood glucose levels; ↓ Insulin levels; Reversed insulin resistance; Improved serum lipid levels; Relieved gut dysbiosis
Chaiyasut et al[51], 2018	↓ Weight Gain; Improved insulin levels (↑ insulin); Recovery progress of hyperglycemia; ↓ HbA1c level (only with cointerventions); ↓ Inflammatory cytokines level
Guilbaud et al[52], 2020	↓ Weight Gain; ↓ Glycemic response 60-120 min; ↑ In HbA1c; ↓Weight of liver; ↓ FL-furosine levels in kidney ↓The expression of TNF-α; ↓The TG concentrations in liver; ↓ HDL and Non-HDL; Lower lipid droplets in liver.
Archer et al[48], 2021	↓ Blood glucose levels; Improved insulin levels (↑ insulin); ↓ levels of cholesterol, triglycerides, and LDL-C; ↓ The expression levels of TNF-α, and ↑ expression of IL-10; ↓ Expression of the TLR4 receptor, ↑ Expression of tight junction protein ZO-1, endocannabinoid receptor CB2 and GLP1, and ↑ Expression of GLUT4 in MAT and muscle tissue; Showed accumulation of neutrophils around the portal tracts in liver tissue, and reduction in the glomerular injury in kidney sections
Ai et al[31], 2021	Inhibit the degree of weight loss; ↓ The fasting blood glucose; ↓ Blood glucose levels; ↓ Levels of total cholesterol and LDL and ↑ HDL levels; Ameliorate the damage to liver cells and significantly reduced the accumulation of lipid droplets; Upregulated the levels of SOD, T-AOC and GSH-PX, and reversed elevation of MDA; ↓ Damage in composition of gut microbiota1
Yadav et al[54], 2018	Inhibit the degree of weight loss; ↓ The fasting blood glucose; ↓ Consumption of food and liquids; ↑ In oral glucose tolerance; ↑ In liver weight; Improved insulin levels (↑ Insulin); ↓ HbA1c level; ↑ CAT, SOD activity in kidney and liver; ↓ Serum levels of total cholesterol, LDL-C, VLDL-C and triglycerides; ↓ The serum inflammatory index, cytokine levels (IL-6 and TNF-α); ↓ In the expression of the genes G6Pase and pepck in the liver
Yousaf et al[55], 2016	↑ Body weight; ↓ Blood glucose levels; Lipid profile: no effect on cholesterol, ↓ tryglyceride, LDL, slight increase in the level of HDL
Balakumar et al[49], 2018	↓ Body weight; ↓ Blood glucose levels; ↑ In oral glucose tolerance; ↓ HbA1c level; Improved insulin levels (↓ Insulin); ↑ levels of GLP-1; ↓ Cholesterol, triglyceride and LDL levels; ↑ HDL level; ↓ Plasma DX-4000–FITC; ↑ mRNA expression of epithelial tight junction occludin and ZO-1; ↓ Serum levels of LPS; ↓ Proinflammatory gene expression profiles (IL6 and TNFα), ↑ adiponectin gene expression; ↓ Gene expression profiles of endoplasmic reticulum stress
Babadi et al[30], 2018	Downregulated gene expression of TNF-α; ↓ The fasting blood glucose; ↓ Serum insulin level; ↓ Insulin resistance; ↑ Insulin sensitivity; ↓ Levels of triglycerides, VLDL-cholesterol and total / HDL-cholesterol ratio, and ↑ levels of HDL-cholesterol; ↓ In plasma MDA; ↑ In plasma NO and total antioxidant capacity

¹These results were obtained by rice bran fermented with Lactobacillus fermentum MF423.

SOD: Superoxide dismutase; HbA1c: Glycayed hemoglobin A; TNF-α: Tumor necrosis factor-alpha; TG: Triglyceride; HDL- C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; VLDL-C: Very-low-density lipoprotein cholesterol; IL-6: Interleukin-6; IL-10: Interleukin-10; TLR4: Toll-like receptor 4; ZO-1: Zonula occludens-1; CB2: Cannabinoid receptor type 2; GLP1: Glucagon-like peptide-1; GLUT4: Glucose transporter type 4; MAT: Mesenteric adipose tissue; T-AOC: Total antioxidant capacity; GSH-PX: Glutathione peroxidase; MDA: Malondialdehyde; CAT: Catalase; G6Pase: Glucose 6-phosphatase; Pepck: Phosphoenolpyruvate carboxykinase; FITC: Fluorescein isothiocyanate-dextran; LPS: Lipopolysaccharide; NO: Nitric oxide.