Fish oil and glycemic control in diabetes. A meta-analysis.
Abstract
OBJECTIVE: Hypertriglyceridemia is associated with cardiovascular disease in diabetes. Fibrates effectively lower, but do not always normalize, serum triglyceride levels. Fish oil supplements may then be added to lower serum triglyceride levels. Doubt remains whether the net effect of fish oil intake on glycemic control is beneficial in diabetes. We therefore performed a meta-analysis from published clinical trials. RESEARCH DESIGN AND METHODS: Data sources were Medline (Cologne, Germany), Excerpta Medica, Current Contents, review articles, and published reference lists. Publications of 26 trials were selected, and all trials included more than five diabetes (IDDM and NIDDM) patients and addressed the effects offish oil (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) on serum lipids and glucose tolerance. We (C.E.F, M.J.F.M.J.) extracted data independently based on predetermined criteria. Studies were classified according to design. RESULTS: All studies combined showed a decrease in mean triglyceride concentrations in association with fish oil: −0.60 mmol/1 (95% CI, −0.84 to −0.33, P < 0.01) and a slight but significant increase in serum LDL cholesterol: 0.18 mmol/1 (95% CI, 0.04−0.32, P = 0.01), with both findings most prominent in NIDDM. No significant changes in HbA1c percentages occurred in diabetic subjects treated with fish oil. Fasting blood glucose levels were increased with borderline significance in NIDDM subjects (0.43 mmol/1 [95% CI, 0.00–0.87], P = 0.06) and were significantly lower in IDDM subjects (−1.86 mmol/1 [95% CI, −3.1 to −0.61], P < 0.05). Significant dose-response effects of EPA (g/day) on HbA1c and triglycerides and of DHA (g/day) on fasting blood glucose levels, HbA1c, and triglycerides were demonstrated only in NIDDM subjects. CONCLUSIONS: The use of fish oil has no adverse affects on HbA1c in diabetic subjects and lowers triglyceride levels effectively by almost 30%. However, this may be accompanied by a slight increase in LDL cholesterol concentration. Fish oil may be useful in treating dyslipidemia in diabetes.
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Two earlier meta-analyses of fish oil supplementation reported increases in LDL similar to those observed with algal oil in this study.
“We also note that two earlier meta-analyses of fish oil supplementation reported increase in LDL similar to those we observed in this study with algal oil (56,57).”
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PPAR-γ response element activity in intact primary human adipocytes: effects of fatty acids
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- Authors
- Friedberg, C. E., Janssen, M. J. F. M., Heine, R. J., & Grobbee, D. E.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Rijnland Ziekenhuis (NL)
- Utrecht University (NL)
- ORCID
- Grobbee, Diederick E
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1998-04-01
- Volume
- 21
- Issue
- 4
- Pages
- 494-500
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2172062221
- Cited by
- 303
- References
- 0
- Citations by year
- 2025: 2 · 2024: 3 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 7 · 2016: 14 · 2015: 11 · 2014: 17 · 2013: 18 · 2012: 11
- FWCI
- 9.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Physical Sciences › Chemistry › Organic Chemistry › Edible Oils Quality and Analysis
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- fish oil, omega-3 fatty acids, eicosapentaenoic acid, docosahexaenoic acid, glycemic control, diabetes mellitus, type 1 diabetes, type 2 diabetes, hypertriglyceridemia, serum triglycerides, LDL cholesterol, HbA1c, fasting blood glucose, dyslipidemia, dose-response relationship, dietary supplementation
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Dietary Fats, Unsaturated, Fish Oils, Glycated Hemoglobin, Humans, Cholesterol, LDL, Triglycerides
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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