The DOI matches its Crossref record.
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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).”
Citations
Cites
Still being checked.
Cited by
Sorted by citations
Items 201–300 of 301
So Many Nutrition Recommendations—Contradictory or Compatible?
Franz, M. J. (2003) · Diabetes Spectrum · doi:10.2337/diaspect.16.1.56 · Cited by 7
NUTRITION MANAGEMENT AND PHYSICAL ACTIVITY AS TREATMENTS FOR DIABETES
Wheeler, M. L. (1999) · Primary Care Clinics in Office Practice · doi:10.1016/s0095-4543(05)70135-4 · Cited by 7
Dunn, S. L. (2009) · UNSWorks (UNSW Sydney) · doi:10.26190/unsworks/22256 · Cited by 7
Revolutionizing Diabetes Care: The Role of Marine Bioactive Compounds and Microorganisms
Reddy, K. T. K., Rakesh, K., Prathyusha, S., Gupta, J. K., Nagasree, K., Ravikumar, L., Elumalai, S., Prasad, P. D., & Kolli, D. (2024) · Cell Biochemistry and Biophysics · doi:10.1007/s12013-024-01508-1 · Cited by 7
Fish, n-3 Polyunsaturated Fatty Acids, and Cardiovascular Disease
McEvoy, C. T., Young, I. S., & Woodside, J. V. (2012) · Humana Press eBooks · doi:10.1007/978-1-61779-894-8_10 · Cited by 7
Cardiometabolic Impact of Non-Statin Lipid Lowering Therapies
Goyal, P., Igel, L. I., LaScalea, K., & Borden, W. B. (2014) · Current Atherosclerosis Reports · doi:10.1007/s11883-013-0390-0 · Cited by 7
Combination lipid therapy in type 2 diabetes mellitus
Vergès, B. L. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2011.558503 · Cited by 6
Cadario, F. (2022) · Nutrients · doi:10.3390/nu14224887 · Cited by 6
Concept of Reference Intake of n-3 Polyunsaturated Fatty Acids in the Japanese Population
Ezaki, O., Sato, S., Sakono, M., Miyake, Y., Mito, N., & Umesawa, M. (2006) · Nippon Eiyo Shokuryo Gakkaishi · doi:10.4327/jsnfs.59.123 · Cited by 6
Stimulant Misuse in College for "Pseudo-Attention Deficit Disorder" During Schizophrenia Prodrome
Freudenreich, O., Cather, C., & Holt, D. J. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.2019 · Cited by 5
Baldwin, E. (2004) · The British Journal of Diabetes · doi:10.1177/14746514040040050901 · Cited by 5
The effect of n-fatty acid (omega 3) on serum visfatin concentration in patients with type2 diabetes
Hosseinzadeh‐Attar, M. J., Hajianfar, H., Bahonar, A., Mohamad, K., Keshavarz, S. A., Entezari, M. H., & Askari, G. (2012) · Pars of Jahrom University of Medical Sciences · doi:10.29252/jmj.10.1.26 · Cited by 5
Diet and Lifestyle in Prevention and Management of Type 2 Diabetes
Hu, F. B. (2006) · Humana Press eBooks · doi:10.1007/978-1-59259-985-1_24 · Cited by 5
Nutrition and diabetes control: advice for non-dietitians
Dyson, P. A. (2002) · British Journal of Community Nursing · doi:10.12968/bjcn.2002.7.8.10647 · Cited by 5
Influence of Flaxseed Oil Administration on Glycemic Response in Active, Healthy Adults
Curran, R., Hildebrandt, L. A., & Schoemer, S. (2002) · Topics in Clinical Nutrition · doi:10.1097/00008486-200212000-00005 · Cited by 5
Fish oils, dyslipidaemia and glycaemic control in diabetes
Mori, T. A. (1999) · Practical Diabetes · doi:10.1002/pdi.1960160712 · Cited by 5
Long-chain n-3 polyunsaturated fatty acids and coronary heart disease
Schmidt, E. B., & Christensen, J. H. (2000) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200003000-00005 · Cited by 5
Kaithala, C., Namburi, H. K., Bandaru, S. S., Bandaru, S. B. S., Adla, N., & Puchchakayala, G. R. (2016) · Romanian Journal of Diabetes Nutrition and Metabolic Diseases · doi:10.1515/rjdnmd-2016-0032 · Cited by 4
Lipids and Diabetes Mellitus: A Review of Therapeutic Options
Goguen, J., & Leiter, L. A. (2002) · Current Medical Research and Opinion · doi:10.1185/030079902125000246 · Cited by 4
Faghihi, T., Ghaeli, P., Adel, J., Mahmoudi‐Gharaei, J., Sharifi, V., & Akhondzadeh, S. (2010) · Europe PMC (PubMed Central) · Cited by 4
Omega-3 Fish Oils and Insulin Resistance
Kasim-Karakas, S. E. (2000) · Modern nutrition · doi:10.1201/9781420036695.ch21 · Cited by 4
Omega-3 Fish Oils and Insulin Resistance
Kasim-Karakas, S. E. (2006) · Modern nutrition · doi:10.1201/9781420006186.ch8 · Cited by 4
Lipid synthesis and encapsulation by Cryptococcus curvatus
Iassonova, D. R. (2009) · Iowa State University Digital Repository (Iowa State University) · doi:10.31274/etd-180810-648 · Cited by 4
Farmacología de los ácidos grasos omega-3
Caballero, R., Gómez, R. J., Núñez, L., Vaquero, M., Tamargo, J. L., & Delpón, E. (2006) · Revista Española de Cardiología Suplementos · doi:10.1016/s1131-3587(06)74822-1 · Cited by 5
Medical Nutrition Therapy for Diabetes
Franz, M. J. (2001) · Humana Press eBooks · doi:10.1007/978-1-59259-226-5_12 · Cited by 3
n-3s from Fish and the Risk of Metabolic Syndrome
Vannice, G. K. (2010) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2010.04.015 · Cited by 3
Lindberg, M., Åsberg, A., Midthjell, K., & Bjerve, K. S. (2013) · Journal of Nutritional Science · doi:10.1017/jns.2013.30 · Cited by 3
Flaxseed oil, a fish oil challenger?
Maurette, J.-M. (2008) · Oléagineux Corps gras Lipides · doi:10.1051/ocl.2008.0211 · Cited by 3
A REVIEW OF OMEGA 3 AND IT’S ROLE IN ORAL DISEASES.
IJAR, Kaur, D. M., Sable, D. D., Chowdhery, A., & Chavan., D. M. (2016) · International Journal of Advanced Research · doi:10.21474/ijar01/1562 · Cited by 3
Application of emerging technologies to obtain valuable lipids from food byproducts
del Río, P. G., Garrote, G., Astray, G., Oliveira, D., Costa, P., & Gullón, B. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-823371-9.00007-1 · Cited by 3
Pharmacological management of hyperlipidaemia
Evans, M., Roberts, A. W., & Rees, A. (2003) · The British Journal of Diabetes · doi:10.1177/14746514030030030901 · Cited by 3
Impact of nutrition information on consumers' food purchases.
Shiratori, S. (2011) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 3
Chawla, I., Dhanawat, M., Sharma, M., & Gupta, S. (2025) · Current Diabetes Reviews · doi:10.2174/0115733998275676240202065952 · Cited by 2
Jun, H.-J., Ko, J., Jung, H.-S., Yoon, C., Kim, T., Kwon, M., Lee, S., Suk, J., Kim, M.-K., Kim, D., et al. (2011) · Endocrinology and Metabolism · doi:10.3803/enm.2011.26.3.218 · Cited by 2
Fatty fish intake, n‐3 fatty acids and self‐rated health in middle‐aged adults
Høstmark, A. T., Tomten, S. E., & Holmboe‐Ottesen, G. (2007) · European Journal of Lipid Science and Technology · doi:10.1002/ejlt.200700016 · Cited by 2
Wong, T.-C., Chang, H.-Y., Wu, P.-Y., Cheng, H.-H., & Yang, S. (2014) · Cited by 2
Fish and Fish Oil for Cardiovascular Disease in Diabetes
Ward, R. E., & Hintze, K. J. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802844-5.00020-8 · Cited by 2
Psychosocial Issues and Type 2 Diabetes
Welch, G. W., Jacobson, A. M., & Weinger, K. (2007) · CRC Press eBooks · doi:10.3109/9780849379581-8 · Cited by 2
DHA-Rich Algae Oil Is a Safe and Effective Vegetarian Source of Omega-3
Doughman, S. D., Krupanidhi, S., & Sanjeevi, C. B. (2016) · Springer eBooks · doi:10.1007/978-3-319-40458-5_21 · Cited by 2
Effect of omega-3 fatty acids on triglycerides and BMI levels in obese children.
Elodia, G.-C., Lauro, F., Gmez, E. P., Daz-Cedillo, F., Marcela, R., Sarabia-Alcocer, B., Njera-Medina, O., Arriaga, R. V., & Garca-Lpez, S. (2015) · Current Pediatric Research · Cited by 2
Goldberg, R. B. (2006) · Fundamental and clinical cardiology · doi:10.3109/9781420019667.006 · Cited by 2
Nutrition in the Etiology and Management of Type 2 Diabetes
Toeller, M., & Mann, J. I. (2007) · CRC Press eBooks · doi:10.3109/9780849379581-6 · Cited by 8
Type 2-diabetes og det metaboliske syndrom - diagnostik og behandling
Beck‐Nielsen, H., Henriksen, J. E., Hermansen, K., Madsen, L. D., Mandrup-Poulsen, T. R., Richelsen, B., & Schmitz, O. (2000) · Research at the University of Copenhagen (University of Copenhagen) · Cited by 2
Ernährungstherapie bei Diabetes
Toeller, M. (2006) · Der Diabetologe · doi:10.1007/s11428-006-0049-3 · Cited by 2
Cardio-protective and Anti-obesity Properties of Polyunsaturated Fatty Acids from Algae
Kariyawasam, K. M. G. M. M., Kariyawasam, K. M. G. M. M., & Wickramasinghe, I. (2025) · Springer eBooks · doi:10.1007/978-981-95-0571-5_11 · Cited by 1
Patients With Diabetes Using Alternative Medicine
Seely, D., Mills, E. J., & Rachlis, B. (2006) · Humana Press eBooks · doi:10.1007/978-1-59745-008-9_21 · Cited by 1
Hiperlipidemi Tedavisinde Omega-3 Yağ Asitinin (Balik Yaği) Etkinliği
Özkan, Y., & Koca, S. S. (2006) · Fırat Tıp Dergisi · Cited by 1
Benefícios da modificação do estilo de vida na síndrome metabólica
Valmorbida, L. A., Borsatto, A. C., Feóli, A. M. P., Antunes, M. T., Breigeiron, M. K., & Macagnan, F. E. (2013) · Fisioterapia em Movimento · doi:10.1590/s0103-51502013000400012 · Cited by 1
18. Polyunsaturated fatty acids, cholesterol, triglycerides and cardiometabolic disease
Mühlhäusler, B. S., & Leghi, G. E. (2016) · Wageningen Academic Publishers eBooks · doi:10.3920/978-90-8686-821-6_18 · Cited by 2
Monteiro, J., McLennan, M., Hillyer, L. M., Askarian, F., Moghadasian, M. H., Nakamura, M., & David, W. L. (2012) · The FASEB Journal · doi:10.1096/fasebj.26.1_supplement.266.1 · Cited by 1
Sukumar, C. A., Ramachandran, A., & Sudeep, K. (2021) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20213082 · Cited by 1
The Effects of Eicosapentaenoic Acid in Various Clinical Conditions
Sinclair, A. J., Wallace, J. M. W., Martin, M. J., Attar‐Bashi, N. M., Weisinger, R. S., & Li, D. (2019) · AOCS Publishing eBooks · doi:10.1201/9780429104497-16 · Cited by 1
Forouhi, N. G., & Wareham, N. J. (2010) · Wiley eBooks · doi:10.1002/9780470682807.ch7 · Cited by 1
Dietary Management: Optimising Diabetes Outcomes
Waldron, S. (2007) · Wiley eBooks · doi:10.1002/9780470692271.ch8 · Cited by 1
Fatty Acids, Insulin Resistance and Diabetes
Juturu, V., & Gormley, J. J. (2008) · Humana Press eBooks · doi:10.1007/978-1-59745-330-1_18 · Cited by 1
Omega-3 fatty acids and other polyunsaturated fatty acids and weight control
Winzell, M. S., & Åhrén, B. (2007) · Elsevier eBooks · doi:10.1533/9781845693114.3.281 · Cited by 1
Invited Review: Cardioprotective Effects of ω‐3 Fatty Acids
Harris, W. S., & O’Keefe, J. H. (2001) · Nutrition in Clinical Practice · doi:10.1177/088453360101600103 · Cited by 1
Suh, H. S. (2015) · University of Southern California Digital Library · doi:10.25549/usctheses-m2519 · Cited by 1
Ernährungstherapie bei Diabetes mellitus
Toeller, M. (2007) · Ernährung - Wissenschaft und Praxis · doi:10.1007/s12082-007-0030-6 · Cited by 1
Dietary Supplementation With Omega-3 Polyunsaturated Fatty Acids
Fedor, D. M., Gill, S. H. S., Adkins, Y. C., & Kelley, D. S. (2008) · Clinical Nutrition INSIGHT · doi:10.1097/01.nmd.0000314191.49725.a0 · Cited by 1
Complications Associated with Diabetes
Mazze, R. S., Strock, E. S., Bergenstal, R. M., Criego, A. B., Cuddihy, R. M., Langer, O., Simonson, G. D., & Powers, M. A. (2011) · doi:10.1002/9781119950424.ch8
Recomendaciones nutricionales en la diabetes
Ballester, L. V. (2005) · Hispana
Grundlagen der Ernährung des Diabetikers
Toeller, M. (2004) · Springer eBooks · doi:10.1007/978-3-642-18571-7_13
The highly unsaturated fatty acids: physiological role and clinical possibilities
Haag, M., & Coetzee, M. (2006) · Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie · doi:10.4102/satnt.v25i4.169
n–3 Fatty Acids and Cardiovascular Disease
Westphal, S., & Luley, C. H. (2002) · Heart Drug · doi:10.1159/000063426
Mattes, J. A. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.2019a
n-3 NEFA: vascular implications
Fegan, P. G. (2002) · European Heart Journal · doi:10.1053/euhj.2001.2945
Omega-3 Fatty Acids: Emerging Role for Cardioprotection
Backes, J. M., & Howard, P. A. (2008) · Hospital Pharmacy · doi:10.1310/hpj4303-178
Song, Y., & He, K. (2010) · North American Journal of Medicine and Science · doi:10.7156/v3i3p140
Dyslipidemia treatment: current considerations and unmet needs
Malik, S., & Kashyap, M. L. (2003) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.1.1.121
Martín-Bautista, E. (2011) · Institutional Repository of the University of Granada (University of Granada)
Caterina, R. D., Madonna, R., Bertolotto, A., Schmidt, E. B., & Sygehus, A. (2007)
Bernstein, A., Ding, L., Willett, W. C., & Rimm, E. B. (2011)
Nutrient regulation of energy metabolism in relation to obesity and type 2 diabetes
Wensaas, A. J. (2010) · NORA - Norwegian Open Research Archives
Hill, A. M. (2007) · Adelaide Research & Scholarship (AR&S) (University of Adelaide)
Dietary Supplements for Geriatric Patients
Pan, C. X., & Mobbs, C. V. (2006) · Springer eBooks · doi:10.1007/0-387-22621-4_63
Schreiber, A. K. (2013) · UFPR Digital Collection (Federal University of Paraná)
Victor, C. T.-S., & Mullin, G. E. (2009) · Clinical Nutrition INSIGHT · doi:10.1097/01.nmd.0000346788.82151.68
Mesquita, E. T., Junior, C. V. S., de Suplemento, Guimarães, J. I., Liberman, B., Mansur, A. J., Sousa, A. G. M. R., Sposito, A. C., Rassi, A., Lopes, A. A., et al. (2005)
de Cardiologia, S. B., Simão, A. F. L., Cunha, V., Guimarães, C., Brandão, A. P., Brandão, A. A., Nogueira, A. D. R., Suplicy, H., & Guimarães, J. I. (2005)
Chapter 4 Proteins, amino acids, and type 2 diabetes
Song, Y., & Liu, S. (2013) · CRC Press eBooks · doi:10.1201/b15389-5
(2011) · The Internet Journal of Nutrition and Wellness · doi:10.5580/875
n-3s from Fish and the Risk of Metabolic
Vannice, S. K. (2010)
Dietary Fatty Acids as Modulators of Adipose Inflammation
Zeyda, M., & Stulnig, T. M. (2009) · Oxidative stress and disease · doi:10.1201/9781420091311.ch11
Nutrition and Type 2 Diabetes Mellitus in the Geriatric Patient
Mazza, A. D. (2007) · Nutrition and disease prevention · doi:10.1201/9781420005493.ch26
Targeting obesity-related inflammation through nutritional and genetic approaches
LeMieux, M. J. (2015) · ThinkTech (Texas Tech University)
Génétique, acides gras oméga-3 et facteurs de risque des maladies cardiovasculaires
Bouchard‐Mercier, A. (2015) · Corpus Université Laval (Université Laval)
Minami, A., Sakamoto, S., Ishimura, N., Niwa, Y., & Nakaya, Y. (2000) · The Journal of Japan Atherosclerosis Society · doi:10.5551/jat1973.27.6_133
Woodman, R. J. (2003) · UWA Profiles and Research Repository (UWA)
Current Comprehension of the Role of Fatty Acids in the Development of Type 2 Diabetes
Chen, G. (2017) · Journal of Nutritional Health & Food Science · doi:10.15226/jnhfs.2017.00199
Die hoogs-onversadigde vetsure: fisiologiese rol en kliniese moontlikhede
Aag, M., & Oetzee, M. (2006)
The Effects of Eicosapentaenoic Acid in Various Clinical Conditions
Sinclair, A. J., Wallace, J. M. W., Martin, M. J., Attar‐Bashi, N. M., Weisinger, R. S., & Li, D. (2005) · AOCS Publishing eBooks · doi:10.1201/9781439822289.ch16
DHA-Rich Algae Oil Is a Safe and Effective Vegetarian Source of Omega-3
Doughman, S. D., Krupanidhi, S., & Sanjeevi, C. B. (2025) · Springer eBooks · doi:10.1007/978-3-031-84200-9_5
de Almeida, R. M., Giannetti, W. D., Silveira, G. R., Castilho, C. R., Lisboa, R. V., Ciambarella, B. T., Ferreira, R. N., & de Carvalho, J. J. (2024) · Journal of Biosciences and Medicines · doi:10.4236/jbm.2024.125017
Caractérisation et prévention des conséquences d'un syndrome métabolique dans la rétine
Vidal, E. (2018) · theses.fr (ABES) · doi:10.70675/09e85feez27afz465az91aaz70fa8efb0c74
Metadata
- 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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review