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Peer-reviewedCC BYFrontiers in medicine

Effects of faecal microbiota transplantation on glycaemic outcomes in adults with metabolic disorders: a systematic review and meta-analysis of randomised controlled trials

  • Maryana Savytska1
  • Viktoriya-Svitlana Halich2
  • Liudmyla Kuzmenko2
  • Iryna Halabitska3
  • Iryna Kamyshna4
  • Pavlo Petakh5
  • Oleksandr Kamyshnyi6
  • Nazarii Kobyliak2
6 affiliations
  1. 1Physiology Department, Danylo Halytsky Lviv National Medical University , ,
  2. 2Bogomolets National Medical University , ,
  3. 3Department of Therapy and Family Medicine, I. Horbachevsky Ternopil National Medical University , ,
  4. 4Department of Medical Rehabilitation, I. Horbachevsky Ternopil National Medical University , ,
  5. 5Department of Biochemistry and Pharmacology, Uzhhorod National University , ,
  6. 6Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University , ,
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Abstract

Background: Faecal microbiota transplantation (FMT) may improve glucose metabolism, but findings from randomised trials and previous meta-analyses are inconsistent. We evaluated the effects of FMT on glycaemic outcomes in adults with type 2 diabetes, prediabetes, insulin resistance or related metabolic disorders.

Methods: We searched PubMed and Scopus for English-language randomised controlled trials published from January 2000 to May 2026. The primary outcome was change from baseline in HOMA-IR. Secondary outcomes included HbA1c, fasting glucose and clamp-derived peripheral insulin sensitivity. Random-effects meta-analyses used Paule–Mandel estimation with Hartung–Knapp–Sidik–Jonkman confidence intervals. Sensitivity analyses evaluated comparator type, data reconstruction, the assumed baseline–follow-up correlation and individual-study influence. Risk of bias was assessed using RoB 2.

Results: The searches identified 887 records, and 18 studies met the eligibility criteria. Six trials involving 120 participants included to the primary analysis. FMT did not significantly reduce HOMA-IR compared with control (MD, −1.29; 95% CI [−3.04, 0.47]; I2 = 72%). The sensitivity analysis combining HOMA-IR and HOMA2-IR also produced a non-significant result (MD, −1.11; 95% CI [−2.50, 0.29]). HbA1c data were sparse and were not pooled across comparator types. Clamp-derived findings suggested a possible donor-phenotype effect but remained inconclusive. The certainty of evidence was very low for HOMA-IR and HbA1c and low for peripheral insulin sensitivity.

Conclusions: FMT did not demonstrate a clear benefit for glycaemic outcomes. The estimates were imprecise, heterogeneous and influenced by comparator design. Larger trials with standardised outcomes and predefined donor phenotypes are required.

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Cite

BibTeXRIS
BibTeX
@article{savytska2026effects,
  title = {{Effects of faecal microbiota transplantation on glycaemic outcomes in adults with metabolic disorders: a systematic review and meta-analysis of randomised controlled trials}},
  author = {Maryana Savytska and Viktoriya-Svitlana Halich and Liudmyla Kuzmenko and Iryna Halabitska and Iryna Kamyshna and Pavlo Petakh and Oleksandr Kamyshnyi and Nazarii Kobyliak},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1983162},
  url = {https://europepmc.org/article/PMC/PMC13719402},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Effects of faecal microbiota transplantation on glycaemic outcomes in adults with metabolic disorders: a systematic review and meta-analysis of randomised controlled trials
AU  - Maryana Savytska
AU  - Viktoriya-Svitlana Halich
AU  - Liudmyla Kuzmenko
AU  - Iryna Halabitska
AU  - Iryna Kamyshna
AU  - Pavlo Petakh
AU  - Oleksandr Kamyshnyi
AU  - Nazarii Kobyliak
PY  - 2026
DA  - 2026/10/16
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1983162
UR  - https://europepmc.org/article/PMC/PMC13719402
AB  - Background: Faecal microbiota transplantation (FMT) may improve glucose metabolism, but findings from randomised trials and previous meta-analyses are inconsistent. We evaluated the effects of FMT on glycaemic outcomes in adults with type 2 diabetes, prediabetes, insulin resistance or related metabolic disorders.  Methods: We searched PubMed and Scopus for English-language randomised controlled trials published from January 2000 to May 2026. The primary outcome was change from baseline in HOMA-IR. Secondary outcomes included HbA1c, fasting glucose and clamp-derived peripheral insulin sensitivity. Random-effects meta-analyses used Paule–Mandel estimation with Hartung–Knapp–Sidik–Jonkman confidence intervals. Sensitivity analyses evaluated comparator type, data reconstruction, the assumed baseline–follow-up correlation and individual-study influence. Risk of bias was assessed using RoB 2.  Results: The searches identified 887 records, and 18 studies met the eligibility criteria. Six trials involving 120 participants included to the primary analysis. FMT did not significantly reduce HOMA-IR compared with control (MD, −1.29; 95% CI [−3.04, 0.47]; I2 = 72%). The sensitivity analysis combining HOMA-IR and HOMA2-IR also produced a non-significant result (MD, −1.11; 95% CI [−2.50, 0.29]). HbA1c data were sparse and were not pooled across comparator types. Clamp-derived findings suggested a possible donor-phenotype effect but remained inconclusive. The certainty of evidence was very low for HOMA-IR and HbA1c and low for peripheral insulin sensitivity.  Conclusions: FMT did not demonstrate a clear benefit for glycaemic outcomes. The estimates were imprecise, heterogeneous and influenced by comparator design. Larger trials with standardised outcomes and predefined donor phenotypes are required.
SN  - 2296-858X
ER  -