Trial studies were included in our analyses if they met the following criteria: (1) being a RCT in either parallel or cross-over design, and at least two arms, (2) limited to DN patients aged ≥18 years and disease duration between 2-20 years, and (3) those which investigated the effect of probiotics (of any form, including capsule, milk, yogurt and honey) on plasma/serum biomarkers of oxidative stress (MDA, TAC, GSH, NO) and hs-CRP concentrations. The studies were excluded if: (1) outcomes had not been clearly stated, (2) they had a nonexperimental (case studies, case series, cross-sectional, case-control, cohort and other retrospective studies) design without clear inclusion and exclusion criteria, (3) they had uncontrolled body, and (4) they were preclinical studies with animal models.

The relevance of articles and abstracts for inclusion was reviewed by two independent reviewers. Then, one reviewer independently evaluated the full text of potentially relevant non-duplicated articles. Disagreements were resolved by discussion or third party opinion.

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