n-3 Fatty Acids in the Treatment of Diabetic Patients

Caterina, Raffaele De; Madonna, Rosalinda; Bertolotto, Alessandra; Schmidt, Erik Berg

doi:10.2337/dc06-1332

Cited by 111 publications

(81 citation statements)

References 167 publications

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“…Blood-pressure reduction with omega-3 PUFA appears to be dose-dependent [46] and again the omega-3 EE90 2 g/day dose used in AFORRD may have been too small. The role of omega-3 EE90 in helping to manage CVD risk in type 2 diabetes remains unclear [47], but the results of two ongoing 10,000 patient clinical endpoint trials, A Study of Cardiovascular Events iN Diabetes (ASCEND) [48] and Outcome Reduction with Initial Glargine Intervention (ORIGIN) [49], which are both using omega-3 EE90 1 g/day, may help to clarify it. The AFORRD trial results have a number of important implications for clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomised controlled trial

et al. 2008

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Aims/hypothesis The aim of the study was to examine the impact of statin or omega-3-acid ethyl esters 90 (omega-3 EE90; omega-3-acid ethyl esters 90 refers to a mixture of ethyl esters of n-3 fatty acids) on estimated cardiovascular disease (CVD) risk in community-based people with type 2 diabetes but without known CVD and not taking lipid-lowering therapy. Methods A central computer randomised 800 patients in 59 UK general practices to atorvastatin (n=401, 20 mg/day) or placebo (n=399) and omega-3 EE90 (n=397, 2 g/day) or placebo (n=403) in a concealed factorial manner. Participants with LDL-cholesterol <2.6 mmol/l, triacylglycerol <1.5 mmol/l and estimated 10-year CVD risk <20% were compared at 4 months.Results Mean (SD) age was 63.5 (11.7) years, HbA 1c 6.9 (1.1) % and known diabetes duration (median [interquartile range]) was 4 (2-8) years. Fifty-seven per cent were men, 90% white and 74% had an estimated 10-year CVD risk ≥20%. Of 732 patients with 4-month data, more allocated atorvastatin (n=371) compared with placebo (n=361) achieved LDLcholesterol <2.6 mmol/l (91% vs 24%, p<0.001) and had estimated 10-year CVD risks <20% (38% vs 26%, p<0.001). No differences were seen between those allocated omega-3 EE90 (n=371) compared with placebo (n=361) for participants achieving triacylglycerol <1.5 mmol/l (65% vs 60%, p=0.18) or estimated 10-year CVD risks <20% (34% vs 30%, p=0.18). There were no side effects of note. Conclusions/interpretation Many community-based diabetic patients without known CVD remain at high CVD risk despite statin treatment and require additional risk-reduction strategies. The impact of omega-3 EE90 on CVD risk will remain uncertain until clinical endpoint trial results are available.

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Section: Discussionmentioning

confidence: 99%

Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomised controlled trial

et al. 2008

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“…Several investigations showed that dietary omega-3 FAs may affect glucose metabolism and plasma lipids both in healthy people and patients with metabolic syndrome [251][252][253][254][255][256][257]. Nevertheless, overall the most representative meta-analysis performed in the last decade showed that omega-3 FA supplementation up to 5 g/day consumed for 3 months do not significantly affect insulin sensitivity and glucose homeostasis both in healthy subjects and diabetic patients [258][259][260][261][262].…”

Section: Adverse Effects Of N-3 Polyunsaturated Fatty Acidsmentioning

confidence: 98%

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Nabavi

Bilotto

Russo

et al. 2015

Cancer Metastasis Rev

139

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Over the past decades, extensive studies have addressed the therapeutic effects of omega-3 polyunsaturated fatty acids (omega-3 FAs) against different human diseases such as cardiovascular and neurodegenerative diseases, cancer, etc. A growing body of scientific research shows the pharmacokinetic information and safety of these natural occurring substances. Moreover, during recent years, a plethora of studies has demonstrated that omega-3 FAs possess therapeutic role against certain types of cancer. It is also known that omega-3 FAs can improve efficacy and tolerability of chemotherapy. Previous reports showed that suppression of nuclear factor-κB, activation of AMPK/SIRT1, modulation of cyclooxygenase (COX) activity, and up-regulation of novel anti-inflammatory lipid mediators such as protectins, maresins, and resolvins, are the main mechanisms of antineoplastic effect of omega-3 FAs. In this review, we have collected the available clinical data on the therapeutic role of omega-3 FAs against breast cancer, colorectal cancer, leukemia, gastric cancer, pancreatic cancer, esophageal cancer, prostate cancer, lung cancer, head and neck cancer, as well as cancer cachexia. We also discussed the chemistry, dietary source, and bioavailability of omega-3 FAs, and the potential molecular mechanisms of anticancer and adverse effects.

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“…Moreover, oral diabetic medication, obesity or insulin resistance and other conditions such as hypertension may also have affected insulin sensitivity [22,31] . Systematic reviews and meta-analyses on the effects of fish oil supplementation on parameters of glucose and insulin metabolism in diabetic and/or dyslipidemic patients conclude that fish oil supplementation in moderate dosages (equivalent to 1-2 g/day LC n-3 PUFA) has no significant adverse effects on glucose tolerance, HbA1c or fasting glucose levels [13,16,21,[31][32][33][34] . However, higher fasting glucose levels in subjects with type 2 diabetes compared to type 1 diabetics after administration of fish oil has been reported in several studies [31] .…”

Section: Discussionmentioning

confidence: 99%

Effects of Dietary α-Linolenic Acid, Eicosapentaenoic Acid or Docosahexaenoic Acid on Parameters of Glucose Metabolism in Healthy Volunteers

Egert¹,

Fobker²,

Andersen³

et al. 2008

Ann Nutr Metab

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Aim: To investigate the effects of α-linolenic acid (ALA) and purified eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) on fasting concentrations of glucose, insulin, fructosamine, on glycosylated haemoglobin (HbA1c) and on insulin sensitivity. Methods: A randomized strictly controlled dietary study in 48 healthy volunteers (13 males, 35 females) of normal body weight (mean age 25.9 years) with three dietary groups (ALA, EPA and DHA) and a parallel design, consisting of two consecutive periods. Subjects received a 2-week wash-in diet rich in monounsaturated fatty acids followed by experimental diets enriched with equal amounts of ALA, EPA, or DHA for 3 weeks. Mean dietary intake of ALA in the ALA group was 6.0 g/day (2.5% of energy intake), mean intake of EPA in the EPA group was 2.8 g/day (1.1% of energy intake) and mean intake of DHA in the DHA group was 2.9 g/day (1.1% of energy intake). Results: Fasting serum concentrations of insulin and fructosamine and of HbA1c did not change significantly after consuming the ALA, EPA or DHA diet. Fasting serum glucose levels did not change significantly following either the ALA or DHA diet. During the EPA diet, fasting glucose concentration slightly increased by 0.15 mmol/l (p < 0.05). All measured values of all subjects were in the reference ranges for healthy adults. No effects on insulin sensitivity indicated by the HOMA insulin resistance index could be observed. Conclusions: Except for the minor effect of EPA on fasting glucose levels, the moderate amounts of dietary ALA, EPA or DHA administered in this study did not significantly affect blood concentrations of glucose, insulin, fructosamine and HbA1c in healthy normal-weight men and women over a time course of 3 weeks.

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n-3 Fatty Acids in the Treatment of Diabetic Patients

Cited by 111 publications

References 167 publications

Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomised controlled trial

Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomised controlled trial

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Effects of Dietary α-Linolenic Acid, Eicosapentaenoic Acid or Docosahexaenoic Acid on Parameters of Glucose Metabolism in Healthy Volunteers

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