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Abstract
The development of diabetes mellitus (DM) is associated with such complications as depression, anxiety, and cognitive decline. An urgent problem is the search for means which can improve the psychosomatic state of patients. Recently, researchers in many countries around the world have begun to study probiotics as agents that can influence the brain functioning. Such probiotics are called psychobiotics — living bacteria that can influence on brain function and improve its psychophysiological state by interacting with the intestinal microbiota. A number of researchers includes prebiotics to psychobiotics, which contribute the increase in beneficial gut bacteria. The gut microbiota encompasses all microorganisms that inhabit the space from the mouth to the rectum. It serves as a fundamental component of the cerebro-intestinal axis — the bidirectional system by which the brain modulates the functions of the gastrointestinal tract. The intestinal microbiota plays an important role in the formation of the hypothalamic-pituitary-adrenal axis, which is involved in the
regulation of many physiological processes. Its stimulation is accompanied by increased production of glucocorticoids, in particular cortisol and corticosterone, known as stress markers. Circulating glucocorticoid concentrations are increased in response to mental and physical stress. They also increase the sense of threat and depress mood, memory and other cognitive functions. Psychobiotics exhibit anxiolytic and antidepressant effects, which are characterized by positive changes in the emotional and cognitive spheres. It turned out that psychobiotics affect the pathogenetic links of the stress response, which are involved in the formation of negative psychosomatic complications in DM. Encouraging results of experimental and clinical studies of psychobiotics have been
obtained, which indicate the promise of their use in the treatment of patients with DM and obesity, as well as in antiaging programs. Further research on the use of psychobiotics in the treatment of psychosomatic disorders in DM is promising.
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