Pre- Probiyotikler ve Diyabet

Diabetes Mellitus, son 10 yılda prevalansı dünya çapında ciddi artış gösteren bir halk sağlığı sorunudur. Çeşitli nedenlere bağlı olarak ortaya çıkan diyabetin patogenezinde yetersiz fiziksel aktivite ve yanlış beslenme alışkanlıklarını içeren olumsuz yaşam tarzı değişikliklerine bağlı olarak meydana gelen insulin direnci ile genetik faktörlerin önemli rol oynadığı kabul gören yaygın görüşler arasındadır. Ancak son yıllarda çevresel faktörlerin de diyabet patogenezindeki etkisini gösteren kanıtlar ortaya çıkmıştır. Bu faktörlerden en çok üzerinde durulan ise mikrobiyotadır. Yürütülen çalışmalarla da mikrobiyotadaki değişen bakteri dengesinin; bağırsak geçirgenliğinde artışa, kanda Glukagon Benzeri Peptid-1 ve Glukagon Benzeri Peptid-2’nin azalmasına ve endotoksin artışına neden olduğu gösterilmiştir. Bu hormonal değişiklikler ve endotoksemi ise hedef organlarda lipogenez, yağ kütlesi, inflamasyon ve makrofaj inflitrasyonunda artış; insülin duyarlılığı, beta hücre kütlesi ve plazma insülin düzeyinde ise azalmaya neden olarak diyabetin ortaya çıkmasına katkıda bulunmaktadır. Diyabetin önüne geçebilmek ya da komplikasyonlarının oluşumunu engelleyebilmek için bağırsak mikrobiyotasında meydana gelen değişikliklerin eski haline getirilmesi ise temel amaçtır. Mikrobiyotayı düzenlemek için esas olan beslenmedir ve son yıllarda yapılan çalışmalarla prebiyotik ve probiyotik müdahaleleri ile bağırsak florasının eski haline getirilebileceği belirtilmektedir. Prebiyotikler ve probiyotiklerin diyabetik hastalarda inflamasyonu azaltmada, kan lipit profilini optimal seviyelerde tutmada, kilo kontrolünü sağlamada, antioksidan savunmayı düzeltmede, insülin duyarlılığını ve pankreas β-hücre fonksiyonlarını iyileştirerek kan şekeri regülasyonunu sağlamada etkili olduğu gösterilmiştir.

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