Objective To explore the effects of probiotic-assisted conventional treatment on intestinal flora, blood glucose homeostasis and neurological function in patients with type 2 diabetes mellitus complicated with stroke.

Methods A total of 93 patients with type 2 diabetes mellitus complicated by stroke were selected as the study subjects and randomly divided into control group (n=46) and experimental group (n=47) using random number table method. The control group received conventional therapy, while the experimental group received probiotics (oral Bifidobacterium, Lactobacillus, and Enterococcus triple viable tablets, 4 tablets/time, twice daily) in addition to conventional therapy. Both groups were treated continuously for 7 days. The intestinal flora (counts of Bifidobacterium, Lactobacillus and Bacteroides), inflammatory markers tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), glycemic parameters fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), largest amplitude of glycemic excursions (LAGE), average blood glucose (BGL-ave), standard deviation of mean blood glucose (BGL-sd), and coefficient of variation of blood glucose (BG-cv), and neurological function National Institutes of Health Stroke Scale (NIHSS) score, improvement rate of neurological function, proportion of patients with modified Rankin Scale (mRS) score≤3, and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score were compared between the two groups after treatment.

Results After treatment, the counts of intestinal flora (Bifidobacterium, Lactobacillus, and Bacteroides) in both groups were higher than those before treatment, and the counts in the experimental group were higher than those in the control group, with statistically significant differences (P < 0.05). The levels of TNF-α, IL-6 and hs-CRP in both groups were lower than those before treatment, and the levels in the experimental group were lower than those in the control group, with statistically significant differences (P < 0.05). The levels of FBG and HbA1c in both groups were lower than those before treatment. The FBG level, LAGE, BGL-sd, and BG-cv in the experimental group were lower than those in the control group, with statistically significant differences (P < 0.05), but there were no statistically significant differences in HbA1c and BGL-ave between the two groups (P>0.05). After treatment, the NIHSS score in the experimental group was lower than that in the control group, while the LOTCA score and improvement rate of neurological function were higher than those in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the proportion of patients with an mRS score ≤3 between the two groups (P>0.05).

Conclusion Probiotic-assisted conventional treatment can regulate the number of intestinal flora in patients with type 2 diabetes mellitus complicated with stroke, relieve inflammatory responses, stabilize blood sugar levels, and improve neurological function.