4.7 Article

Omega-3 fatty acids supplementation improves early-stage diabetic nephropathy and subclinical atherosclerosis in pediatric patients with type 1 diabetes: A randomized controlled trial

Journal

CLINICAL NUTRITION
Volume 42, Issue 12, Pages 2372-2380

Publisher

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.clnu.2023.10.0

Keywords

Type 1 diabetes; Diabetic nephropathy; Omega-3 fatty acids; UACR; KIM-1; Carotid intima media thickness

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This study aimed to evaluate the effects of oral omega-3 supplementation on pediatric patients with type 1 diabetes mellitus (T1DM) and diabetic nephropathy. The results demonstrated that omega-3 fatty acids significantly improved glycemic control, dyslipidemia, delayed disease progression, and subclinical atherosclerosis in these patients.
Background: Numerous studies have evaluated the beneficial effects of omega-3 fatty acids on inflammatory, autoimmune and renal diseases. However, data about the effects of omega-3 fatty acids on diabetic kidney disease in type 1 diabetes mellitus (T1DM) are lacking.Objectives: This randomized-controlled trial assessed the effect of oral omega-3 supplementation on glycemic control, lipid profile, albuminuria level, kidney injury molecule-1 (KIM-1) and carotid intima media thickness (CIMT) in pediatric patients with T1DM and diabetic nephropathy.Methods: Seventy T1DM patients and diabetic nephropathy were enrolled with a mean age 15.2 +/- 1.96 years and median disease duration 7 years. Patients were randomly assigned into two groups; intervention group which received oral omega-3 fatty acids capsules (1 g daily). The other group received a matching placebo and served as a control group. Both groups were followed-up for 6 months with assessment of fasting blood glucose (FBG), HbA1c, fasting lipids, urinary albumin creatinine ratio (UACR), KIM-1 and CIMT.Results: After 6 months, omega-3 fatty acids adjuvant therapy for the intervention group resulted in a significant decrease in FBG, HbA1c, triglycerides, total cholesterol, LDL-cholesterol, UACR, KIM-1 and CIMT, whereas, HDL-cholesterol was significantly higher post-therapy compared with baseline levels and compared with the control group (p < 0.05). Baseline KIM-1 levels were positively correlated to HbA1c, UACR and CIMT. Supplementation with omega-3 fatty acids was safe and well-tolerated.Conclusions: Omega-3 fatty acids as an adjuvant therapy in pediatric T1DM patients with diabetic nephropathy improved glycemic control, dyslipidemia and delayed disease progression and subclinical atherosclerosis among those patients. This trial was registered under ClinicalTrials.gov Identifier no. NCT05980026.

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