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Fish oil and glycemic control in diabetes: a meta-analysis
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Journal Article
Fish oil and glycemic control in diabetes: a meta-analysis
1998
Overview
Fish oil and glycemic control in diabetes. A meta-analysis.
C E Friedberg ,
M J Janssen ,
R J Heine and
D E Grobbee
Department of Internal Medicine, Ziekenhuis der Vrije Universiteit, Amsterdam, The Netherlands. c.friedberg.buro@vu.med.nl
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 of fish 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/l (95% CI, -0.84 to -0.33, P < 0.01) and a slight
but significant increase in serum LDL cholesterol: 0.18 mmol/l (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/l [95% CI, 0.00-0.87], P = 0.06) and were
significantly lower in IDDM subjects (-1.86 mmol/l [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.
Publisher
American Diabetes Association
Subject
/ analysis
/ Biological and medical sciences
/ blood
/ DIABETE
/ DIABETES
/ Diabetes Mellitus - diet therapy
/ Diabetes Mellitus, Type 1 - blood
/ Diabetes Mellitus, Type 1 - diet therapy
/ Diabetes Mellitus, Type 2 - blood
/ Diabetes Mellitus, Type 2 - diet therapy
/ Glucose
/ Glycated Hemoglobin A - analysis
/ Humans
/ PATIENTS
