Endocrine Abstracts

Background: Omega-3 polyunsaturated fatty acids are found in fish oil and they have been shown to mitigate the risk of cardiovascular disease. The mechanisms of which are not only improvement of triglycerides and various lipid parameters, but also beneficial effects on arrhythmia, inflammation. There are animal experimental results that omega-3 fatty acid can improve insulin resistance related to obesity and non-alcoholic steatohepatitis. The mechanism can be activation of PPAR-r related to insulin sensitivity, GLUT2 and GLUT4 related to glucose transport, IRS1 and IRS2 related to insulin receptor. Anti-inflammatory effect and inducement of AMPK phosphorylation that is important in energy metabolism can also contribute to the mechanism of improving insulin resistance. But studies about its effects on insulin resistance are limited and the results were not consistent. So, we compared the change of insulin resistance after omega-3 polyunsaturated fatty acids treatment in type 2 diabetes.

Method: We recruited 180 type 2 diabetic patients whose triglyceride level was above 200 mg/dl during the anti-diabetic medication. They were prescribed 2000 mg/day of omega-3 polyunsaturated fatty acids without changing of other medication. HOMA-IR level before and after medication was compared.

Results: HOMA-IR was improved by 3.06±1.73 in 56% (100/180) of patients and aggravated by −2.55±3.87 in 44% of patients. The mean change of HOMA-IR in whole group was 0.57±3.89. The change of HOMA-IR was independent of improvement in triglyceride level or other factors such as BMI, HgA1c level, duration of diabetes.

Conclusion: Omega-3 polyunsaturated fatty acids treatment in type 2 diabetes has no effect on insulin resistance by HOMA-IR measurement.