{
  "abstract": "Background\n\nPainful diabetic neuropathy (PDN) is a relatively common complication of diabetes. Experimental studies have shown that dysbiosis can act as a key factor in neural hypersensitivity and pain perception. We aim to assess the effect of synbiotics on PDN.Materials and methods\n\nIn a randomized, double-blind clinical trial, 60 patients with painful diabetic neuropathy (PDN) were assigned to receive either a synbiotic (a 10⁹ CFU blend of Lactobacillus, Bifidobacterium, and Streptococcus strains and 74 mg of fructooligosaccharides) or a placebo for eight weeks.Results\n\nCompared to placebo, synbiotic significantly decreased the numerical rating score for pain (synbiotic: from 7.60 ± 0.85 to 3.20 ± 1.80; placebo: from 7.83 ± 0.95 to 6.43 ± 1.85; P < 0.001), reduced sleep interference (synbiotic: from 6.83 ± 1.46 to 2.60 ± 1.69; placebo: from 6.83 ± 1.46 to 5.33 ± 2.64; P < 0.001), and enhanced six out of eight domains of the 36-Item Short Form Health Survey questionnaire. Analysis of pain types in the short-form McGill Pain Questionnaire-2 showed significant improvements in hot-burning pain (P = 0.032), cold-freezing pain (P = 0.018), and tingling (P < 0.001), whereas numbness and other investigated pain types did not show significant changes during the intervention period. Furthermore, body mass index, fasting blood insulin and glucose levels, and blood pressure did not change after intervention.Conclusion\n\nIn conclusion, this study highlights the potential efficacy of synbiotic in alleviating pain and improving sleep and quality of life in patients with PDN.Trial registration\n\nIranian Registry of Clinical Trials (IRCT20090901002394N49), registered on 31 July 2023.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Islamic Republic of Iran.",
    "Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.",
    "Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Islamic Republic of Iran. jazayeri.sh@iums.ac.ir.",
    "Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, Iran. jazayeri.sh@iums.ac.ir."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Manoochehr Amin Amlashi"
    },
    {
      "affs": [
        1
      ],
      "name": "Nahid Hashemi-Madani"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Shima Jazayeri",
      "orcid": "0000-0002-6013-4209"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bxf8ra1jd3gqr.bib",
  "cited_by": 0,
  "doi": "10.1186/s13098-026-02244-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13729653",
  "id": "bxf8ra1jd3gqr",
  "issns": [
    "1758-5996"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972388",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2737|Pain Mechanisms and Treatments"
    ]
  ],
  "openalex": "W7172537612",
  "pdf_url": "https://europepmc.org/articles/PMC13729653?pdf=render",
  "pmcid": "PMC13729653",
  "pmid": "42972388",
  "published": "2026-08-05",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/bxf8ra1jd3gqr.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42972388",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972388"
    },
    {
      "first_seen": "2026-11-07T12:22:22Z",
      "native_id": "PMC13729653",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13098-026-02244-7"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Pain Mechanisms and Treatments",
      "subfield": "physiology"
    }
  ],
  "title": "Effects of synbiotic supplementation on clinical symptoms and metabolic outcomes in patients with painful diabetic neuropathy: a pilot randomized controlled trial.",
  "title_text": "Effects of synbiotic supplementation on clinical symptoms and metabolic outcomes in patients with painful diabetic neuropathy: a pilot randomized controlled trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:22Z",
  "url": "https://research.draconitic.com/paper/bxf8ra1jd3gqr",
  "venue": "Diabetology & metabolic syndrome",
  "versions": []
}