IntroductionThe first 1,000 days of life represent a critical window for establishing lifelong health, during which rapid immune, metabolic, and neurodevelopmental changes are closely linked to the maturation of the gut microbiota. Disruptions in early microbial colonisation may adversely affect these developmental processes, increasing susceptibility to infections, allergies, and other adverse health outcomes. Recent research highlights the potential of prebiotics and human milk oligosaccharides (HMOs) to modulate the gut microbiota, restore microbial balance, and support healthy early-life development. Therefore, this study aimed to gather expert insights on the role of prebiotic and HMO interventions in shaping early-life health outcomes.MethodsA 12-member group of paediatric and neonatal experts from India reviewed the available evidence to assess the role of targeted prebiotic nutritional interventions in shaping early-life health outcomes. A modified Delphi-based approach was used to harness collective expertise through iterative feedback. Based on the available evidence and expert input, 24 preliminary statements were developed in three domains: (1) from gut to stool: indicators of infant health; (2) interplay between the gut microbiome and immune regulation; and (3) understanding the gut–brain crosstalk. Following consolidation of overlapping content, 21 scientific statements were finalised for voting. Consensus was predefined as ≥70% agreement (agree/strongly agree) with a median Likert score of ≥4.ResultsExperts reached high agreement (92%–100%) on the role of prebiotics and HMOs in supporting gut, immune, and brain development via gut modulation. The experts agreed that nutritional supplementation with targeted prebiotics such as short-chain galactooligosaccharides/long-chain fructooligosaccharides (9:1) may improve stool consistency, gastrointestinal tolerance, and digestive comfort while reducing infection risk. The experts opined that a 5-HMO blend may enhance gut barrier integrity, modulate immune responses, and lower inflammatory markers, and that sialylated HMOs, particularly 3′-sialyllactose and 6′-sialyllactose, may support neurodevelopment through improved cognitive and language outcomes and greater neuronal connectivity.DiscussionTargeted nutritional interventions using prebiotics and HMOs may support healthy gut microbiota development, immune regulation, and neurocognitive growth in early life. These strategies hold promise for improving health outcomes, particularly for infants who are not exclusively breastfed.
ABSTRACT Introduction Given the significant burden that diabetes self‐management poses, it is important to assess patient‐reported outcomes (PROs) for Type 2 diabetes (T2D) treatments in clinical trials and real‐world studies. Complex insulin regimens are associated with increased risk of hypoglycaemia and body weight gain, which could negatively impact treatment adherence and, therefore, achievement of glycaemic targets. iGlarLixi is a once‐daily fixed‐ratio combination of insulin glargine 100 U/mL and the glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA), lixisenatide. iGlarLixi is an effective treatment alternative to complex insulin regimens, with a favourable between‐group difference in body weight and reduced risk of hypoglycaemia. Methods This is the first review to summarise data from multiple validated PRO measures for recent iGlarLixi studies (Soli‐CGM, SoliMix, Soli‐SWITCH, IDEAL, SUCCESS and SIMPLIFY JP), including: Global Treatment Effectiveness Evaluation, Audit of Diabetes Dependent Quality of Life, Diabetes Medication Satisfaction Tool, Diabetes Therapy‐Related Quality of Life, Diabetes Treatment Satisfaction Questionnaire, Hypoglycaemic Attitudes and Behaviour Scale and Treatment‐Related Impact Measure Diabetes. Results In clinical studies, once‐daily iGlarLixi was associated with numerical improvements in selected treatment satisfaction measures in those who switched from: complex insulin regimens (once‐ or twice‐daily premixed insulin and basal‐bolus insulin), basal insulin or oral glucose‐lowering medications. Additionally, in real‐world studies, iGlarLixi was generally associated with improvements in treatment satisfaction and quality of life outcomes in adults with T2D who previously received basal‐bolus insulin or oral glucose‐lowering medications ± basal insulin or GLP‐1 RAs. Conclusions In conclusion, a once‐daily injection of iGlarLixi may offer a clinically beneficial, simplified treatment option for adults with T2D compared with complex insulin‐based regimens.
