Objective: To test whether adding a daily synbiotic to stable vildagliptin–metformin improves clustered cardiometabolic risk in older adults with type 2 diabetes.
Methods: In a randomized, open-label, parallel-group trial at a tertiary hospital in Tamil Nadu, India, participants ≥60 years on vildagliptin–metformin were assigned 1:1 to synbiotic or standard care for six months (n=210; 105 per group). The primary outcome was change in triglyceride–glucose (TyG) index; secondary outcomes were BMI, waist–hip ratio (WHR), neck circumference, systolic/diastolic blood pressure (SBP/DBP), and triglyceride/HDL ratio. Analyses used baseline-adjusted ANCOVA and repeated-measures tests.
Results: Compared with controls, the synbiotic group showed larger reductions in BMI (−1.48±0.62 vs −0.42±0.39 kg/m²), WHR (−0.03±0.03 vs −0.01±0.02), neck circumference (−1.1±0.7 vs −0.3±0.5 cm), SBP (−8.6±5.1 vs −3.1±4.2 mmHg), and DBP (−5.2±3.6 vs −1.7±2.9 mmHg). Lipid/insulin-resistance markers also improved: TG/HDL (Δ −0.52) and TyG (Δ −0.32). All between-group differences were statistically significant.
Conclusion: In elderly adults with type 2 diabetes, adding a synbiotic to vildagliptin–metformin for six months reduced adiposity measures, blood pressure, and metabolic risk markers, supporting synbiotics as a simple adjunct to improve cardiometabolic risk.
Keywords: Synbiotics; Vildagliptin; Metformin; Elderly; Type 2 Diabetes Mellitus; Metabolic Syndrome; Triglyceride–Glucose Index; Blood Pressure; Insulin Resistance.
How to cite this article: Kala P, Rani JR, Kumar AHSA, Evaluating The Adjunctive Role Of Synbiotic With Vildagliptin-Metformin In Elderly With Type 2 Diabetes Mellitus On Modulating Metabolic Syndrome. Int J Drug Deliv Technol. 2026;16(2s): 495-500; DOI: 10.25258/ijddt.16.495-500