{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T23:02:41Z","timestamp":1787094161709,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n \n Although constipation is a major complication of type 2 diabetes mellitus and chronic kidney disease, evidence for its treatment in these patients remains limited. This study aimed to evaluate the therapeutic efficacy of\n Bifidobacterium bifidum<\/jats:italic>\n for constipation in these patients.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n In this multicenter, open\u2010label, single\u2010arm trial, 30 patients with type 2 diabetes mellitus and chronic kidney disease complicated by constipation were administered\n Bifidobacterium bifidum<\/jats:italic>\n G9\u20101 for 12\u2009weeks. The primary endpoint was the proportion of patients with normal stool form (Bristol Scale score \u22653.5 to <4.5). Secondary endpoints included stool form, defecation frequency, and quality of life.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The proportion of patients with normal stool form at week 12 (44.8%; 13 patients) was significantly higher than that at baseline (3.3%; 1 patient;\n P<\/jats:italic>\n \u2009=\u20090.002). The median Bristol score significantly increased from baseline by 0.6 at week 6 (\n P<\/jats:italic>\n \u2009<\u20090.001) and 0.5 at week 12 (\n P<\/jats:italic>\n \u2009<\u20090.001). Defecation frequency significantly increased by 0.2\u2009\u00b1\u20090.4 from baseline to week 6 (\n P<\/jats:italic>\n \u2009=\u20090.026). The total constipation, abdominal pain, and indigestion scores on the Gastrointestinal Symptom Rating Scale significantly decreased. Abdominal symptoms, including straining, feelings of incomplete evacuation, bloating, and discomfort, significantly decreased. Glycated hemoglobin and the estimated glomerular filtration rate did not change significantly, whereas urinary albumin levels significantly decreased at week 6.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n Bifidobacterium bifidum<\/jats:italic>\n improved stool form, defecation frequency, and quality of life of patients with type 2 diabetes mellitus and chronic kidney disease complicated by constipation, without worsening glycemic control and renal function.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jdi.70236","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T13:20:16Z","timestamp":1767878416000},"page":"470-482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of probiotics (\n Bifidobacterium bifidum<\/i>\n G9<\/scp>\n \u20101) in patients with type 2 diabetes mellitus and chronic kidney disease complicated by constipation: An exploratory, multicenter, open\u2010label, single\u2010arm study (\n BIRDIE<\/scp>\n study)"],"prefix":"10.1111","volume":"17","author":[{"given":"Fuki","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Medicine, Diabetology and Endocrinology Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Sugawara Clinic Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Satoh","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Urayasu Hospital Juntendo University Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"},{"name":"Sugawara Clinic Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Uzawa","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Diabetology and Endocrinology Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina","family":"Muto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Diabetology and Endocrinology Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Watada","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Ministry of Health Labour and Welfare of Japan.The national health and nutrition survey 2016 (in Japanese).http:\/\/www.mhlw.go.jp\/bunya\/kenkou\/kenkou_eiyou_chousa.html."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-021-02105-9"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8121862"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.02.011"},{"key":"e_1_2_9_7_1","volume-title":"Evidence\u2010based clinical practice guidelines for chronic constipation 2023 (in Japanese)","author":"The Japanese Gastroenterological 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