Prebiotics and their activity for the handling of diabetes: Literature review

Prebiotics are non-digestible substance that provides a positive physiological effect by selectively stimulating the growth or action of a limited number of indigenous bacteria in the host. Form previous decade there is increase in public interest and demand for the development of new product and prebiotics formula to improve quality of life. Prebiotics are also used to treat type 2 diabetes by activation of receptors and microorganism recognition in the intestinal lumen. Assumed as pivotal role for treatment of metabolic disorders including major potential for intestinal microfl ora perspective. Also result in improvement of insulin sensitivity and reduction of autoimmune response. However, further researches are required to clarify whether the administration of probiotics can be profi ciently used for the prevention and treatment of type 2 diabetes. Review Article Prebiotics and their activity for the handling of diabetes: Literature review Muhammad Shahazad Manzoor* and Zia Ul Mustafa 1Department of Food Science and Nutrition, DHQ hospital Pakpattan, Pakistan 2Department of Pharmacy, DHQ hospital Pakpattan, Pakistan Received: 21 May, 2019 Accepted: 29 July, 2019 Published: 30 July, 2019 *Corresponding author: Muhammad Shahazad Manzoor, Department of Food Science and Nutrition, DHQ Hospital Pakpattan, 57400, Punjab, Pakistan, Tel: +923056455649, E-mail:


Introduction
have benefi cial effect on host like improving digestion, enhancing mineral absorption and strengthen the immune system [3,4].
In Supermarket huge variety of baby formulas present that function as prebiotics for growth and development of baby.
Some of them are iron fortifi ed while other is essential fatty acid like Arachidonic acid (ARA) and docosahexaenoic acid (DHA); necessary for child optical, cognitive and brain development.
Infant formulas are lactose free for lactose intolerance baby and while some lactose rich formulas are also available in the market. Choosing a best infant formula based on composition and effect on baby health is very important.
There are different types of formula. First one is ready to use formula that doesn't require mixing or measuring.
You just have to open it and serve to newborn in the hospital and are hygiene but these formulas have short half life of 48 hrs. Second are powder formula are most economically and commercially use baby formula but these require time for preparing them and must follow the instruction. Last one is liquid formulas that need mixing equal parts of water with formula based on instruction prescribed on formula packing. These formulas are cheaper and require less storage space then other and expensive as compared to powdered formula.

Formula milk for babies
There are different types of formula that suit every child needs that are given below. Cow milk based formula; Cow milk is main ingredient in these babies' formulas. The manufacturer modifi es the protein of the milk that's easier for children to digest. Soy-based Formula; in this brand modify the plant protein to ease its digestion and recommended when you are vegetarian or your child face problem in digesting cow based milk formula. Lactose-free formula; these are giving to child's that suffered from lactose intolerance that is rare condition. If it is detected, to the pediatrician will recommend a formula that has corn syrup instead of lactose. Extensively hydrolyzed formula; in this formula, they breakdown large protein in smaller to make easier for baby to digest. These are

Review of literature
Breast milk is ideal food for infant child and growth. In the absence of breast milk, different formula milk is given to child but these are not appropriate to fulfi ll the nutritional needs of the infant. Research data show that both of prebiotics and probiotics could safely add in to food is needed during fi rst month of life. It is important to highlight the importance of healthy intestinal microfl ora [5]. The GIT micro fl ora of breastfeeding infant differ from the formula fed infants because the mother milk contain oligosaccharides prebiotics and small amount of probiotics while artifi cial formula does not have that property. Infants on formula milk have lower stool pH, less stool consistency and frequency while less concentration of bifi diobacteria in their intestine as compared to milk feeding infants. Prebiotics formula brings infant formula one step closer to breast milk and having signifi cance health benefi ts throughout the alteration of the gut microfl ora [6,7].
The composition of microfl ora is different for each individual and intestinal bacteria is of three types that are (a) lactobacilli and befi dobacteria (b) pathogenic bacteria alike some species of clostridium (c) commensal bacteria such as bacteriods that have both positive and negative behavior [8,9]. Oligosacchride in human milk act like growth factor for befi dobacteria in the infant gut while milk oligosaccharide act as prebiotics and act as soluble receptor for gut pathogens that make resistance for pathogens that's why these are immunomodulatory [10].
Human milk oligosaccharides (HMOs) are unconjugated glycans that are similar to human milk and revealed as prebiotic "bifi dus factor'' serve as metabolic substrate for bacteria and shape of intestinal microfl ora composition. These are also suggested as antiadhesive, and antimicrobial nutrient that serve as soluble decoy receptor, reduce mucosal leukocyte infi ltration, activation, and lesser the risk of enteroclitis; also offer essential nutrition like EPA & DHA for brain and cognitive development [11]. in immunomodulation, infection anticipation [19]. Type 1 diabetes is most common disease in children having long term complication leading to disability in adults and this is due to genetic, environmental, focus on dietary intake and microfl ora relationship that play an important role in primary and secondary prevention of type 1diabetes [20].

Pre-clinical studies
Gut microfl ora is a tool used for treating of metabolic disorder like diabetes, obesity and other disease. Alteration in the gut microfl ora by using prebiotics; improve gut fence functioning, metabolic endotexemia and infl amtion for the above diseases [21][22][23]. Basically there is alteration in the occluding and zonula occludin zo-1 result in membrane permeability and infl ammation caused by prebiotics with the regulation of GLP-2 [21]. Proglucagon (GLP-2 precursor) modulate the gut microfl ora and increase the number of cell by enteroendocrine L cell and study show that usage of prebiotcs alter bacterial taxa and more abundance relate to positively or negatively with the cell number [24].
When there is change in the gut permeability due to diabetes the body weight decrease, fat mass accumulation, insulin resistance and lipid metabolism is disturb in that case prebiotcis modulate the GLP-1, peptide YY, gherlin. This enhances the GLP-1 receptor activity and glucose homeostasis and improves in diabetes [17,21,24].

Human intervention studies
Inference on healthy individual with non digestible carbohydrate results in increase in satiety level with low food intake [25]. Prebiotics increase satiety and decrease in hunger and this describe about the change in postprandial plasma DOI: http://dx.doi.org/10.17352/jfsnt.000017 glucose level response and gut microfl ora alteration due to prebiotics intake that improve short chain fatty acid and peptide level in gut microfl ora [26][27][28]