DM: Omega-3 Fatty Acids (2014)

DM: Omega-3 Fatty Acids (2014)

• Intervention
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on glycemia (A1C or glucose)?

  • Conclusion

    Seven out of eight studies regarding effect of omega-3 fatty acid supplementation, independent of weight loss, reported no significant effect on A1C or glucose levels in adults with type 1 or type 2 diabetes.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on glycemia (A1C or glucose)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Connor WE, Prince MJ, Ullmann D, Riddle M, Hatcher L, Smith FE, Wilson D. The hypotriglyceridemic effect of fish oil in adult-onset diabetes without adverse glucose control. Annals of the New York Academy of Sciences, 1993; 683: 337-340.
      • Goh YK, Jumpsen JA, Ryan EA, Clandinin MT. Effect of omega-3 fatty acid on plasma lipids, cholesterol and lipoprotein fatty acid content in NIDDM patients. Diabetologia, 1997; 40 (1): 45-52.
      • Holman RR, Paul S, Farmer A, Tucker L, Stratton IM, Neil HA, Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes Study Group. Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomized controlled trial. Diabetologia, 2009; 52 (1): 50-59.
      • McManus RM, Jumpson J, Finegood DT, Clandinin MT, Ryan EA. A comparison of the effects of n-3 fatty acids from linseed oil and fish oil in well-controlled type II diabetes. Diabetes Care, 1996; 19 (5): 463-467.
      • Morgan WA, Raskin P, Rosenstock J. A comparison of fish oil or corn oil supplements in hyperlipidemic subjects with NIDDM. Diabetes Care, 1995; 18: 83-86.
      • Pan A, Sun J, Chen Y, Ye X, Li H, Yu Z, Wang Y, Gu W, Zhang X, Chen X, Demark-Wahnefried W, Liu Y, Lin X. Effects of a flaxseed-derived lignan supplement in type 2 diabetic patients: a randomized, double-blind, crossover trial. PLoS One. 2007; 2 (11): e1,148.
      • Rossing P, Hansen BV, Nielsen FS, Myrup B, Holmer G, Parving HH. Fish oil in diabetic nephropathy. Diabetes Care, 1996; 19 (11): 1,214-1,219.
      • Wong CY, Yiu KH, Li SW, Lee S, Tam S, Lau CP, Tse HF. Fish-oil supplement has neutral effects on vascular and metabolic function but improves renal function in patients with type 2 diabetes mellitus. Diabet Med. 2010; 27 (1): 54-60.
  • Search Plan and Results: DM: Omega-3 Fatty Acids 2013
     
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on insulin levels (exogenous or endogenous)?

  • Conclusion

    Studies regarding the effect of omega-3 fatty acid supplementation, independent of weight loss, reported no significant effect on endogenous insulin levels in adults with type 2 diabetes.  

    No studies were reported on the effect of omega-3 fatty acid supplementation on exogenous insulin levels. Additional long-term studies are needed to ascertain the effect of omega-3 supplementation, independent of weight loss, on insulin levels in adults with diabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on insulin levels (exogenous/endogenous)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Goh YK, Jumpsen JA, Ryan EA, Clandinin MT. Effect of omega-3 fatty acid on plasma lipids, cholesterol and lipoprotein fatty acid content in NIDDM patients. Diabetologia, 1997; 40 (1): 45-52.
      • McManus RM, Jumpson J, Finegood DT, Clandinin MT, Ryan EA. A comparison of the effects of n-3 fatty acids from linseed oil and fish oil in well-controlled type II diabetes. Diabetes Care, 1996; 19 (5): 463-467.
      • Pan A, Sun J, Chen Y, Ye X, Li H, Yu Z, Wang Y, Gu W, Zhang X, Chen X, Demark-Wahnefried W, Liu Y, Lin X. Effects of a flaxseed-derived lignan supplement in type 2 diabetic patients: a randomized, double-blind, crossover trial. PLoS One. 2007; 2 (11): e1,148.
  • Search Plan and Results: DM: Omega-3 Fatty Acids 2013
     
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on CVD risk factors (lipids or blood pressure)?

  • Conclusion

    Research regarding the effect of omega-3 fatty acid supplementation, independent of weight loss, reported significant dose-dependent decrease in triglyceride levels, particularly in individuals with hypertriglyceridemia. However, research regarding omega-3 fatty acid supplementation reported no significant or beneficial effect on total cholesterol, HDL-cholesterol, LDL-cholesterol levels and blood pressure.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of omega-3 fatty acids, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Connor WE, Prince MJ, Ullmann D, Riddle M, Hatcher L, Smith FE, Wilson D. The hypotriglyceridemic effect of fish oil in adult-onset diabetes without adverse glucose control. Annals of the New York Academy of Sciences, 1993; 683: 337-340.
      • Goh YK, Jumpsen JA, Ryan EA, Clandinin MT. Effect of omega-3 fatty acid on plasma lipids, cholesterol and lipoprotein fatty acid content in NIDDM patients. Diabetologia, 1997; 40 (1): 45-52.
      • Holman RR, Paul S, Farmer A, Tucker L, Stratton IM, Neil HA, Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes Study Group. Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomized controlled trial. Diabetologia, 2009; 52 (1): 50-59.
      • McManus RM, Jumpson J, Finegood DT, Clandinin MT, Ryan EA. A comparison of the effects of n-3 fatty acids from linseed oil and fish oil in well-controlled type II diabetes. Diabetes Care, 1996; 19 (5): 463-467.
      • Morgan WA, Raskin P, Rosenstock J. A comparison of fish oil or corn oil supplements in hyperlipidemic subjects with NIDDM. Diabetes Care, 1995; 18: 83-86.
      • Pan A, Sun J, Chen Y, Ye X, Li H, Yu Z, Wang Y, Gu W, Zhang X, Chen X, Demark-Wahnefried W, Liu Y, Lin X. Effects of a flaxseed-derived lignan supplement in type 2 diabetic patients: a randomized, double-blind, crossover trial. PLoS One. 2007; 2 (11): e1,148.
      • Rossing P, Hansen BV, Nielsen FS, Myrup B, Holmer G, Parving HH. Fish oil in diabetic nephropathy. Diabetes Care, 1996; 19 (11): 1,214-1,219.
      • Wong CY, Yiu KH, Li SW, Lee S, Tam S, Lau CP, Tse HF. Fish-oil supplement has neutral effects on vascular and metabolic function but improves renal function in patients with type 2 diabetes mellitus. Diabet Med. 2010; 27 (1): 54-60.
  • Search Plan and Results: DM: Omega-3 Fatty Acids 2013