Eicosapentaenoic Acid Improves Glycemic Control in Elderly Bedridden Patients with Type 2 Diabetes

Eicosapentaenoic Acid Improves Glycemic Control in Elderly Bedridden Patients with Type 2 Diabetes

SUSUMU OGAWA,^1,2 TAKAAKI ABE,^3,4 KAZUHIRO NAKO,¹ MASASHI OKAMURA,¹ MIHO SENDA,¹ TAKUYA SAKAMOTO,¹ SADAYOSHI ITO¹ and THE DIMS STUDY GROUP

¹Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan
²Center for the Advancement of Higher Education, Tohoku University, Sendai, Miyagi, Japan
³Division of Medical Science, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
⁴Department of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are ω3-polyunsaturated fatty acids mainly contained in the blue-backed fish oil, and are effective in decreasing the lipids disorder and the cardiovascular incidence among diabetic patients. Moreover, it has been suggested that EPA and DHA may improve the insulin resistance and glucose metabolism. However, the clinical effects of EPA and DHA on glucose metabolism remain unclear. We aimed to clarify the effects of EPA/DHA treatment on glycemic control in type 2 diabetes mellitus. This study was a multicenter prospective randomized controlled trial involving 30 elderly type 2 diabetic patients on a liquid diet. Their exercises were almost zero and the content of their meals was strictly managed and understood well. Therefore, the difference by the individual's life was a minimum. The subjects were divided into two groups: those receiving EPA/DHA-rich liquid diet [EPA/DHA (+)] or liquid diet lacking EPA/DHA [EPA/DHA (−)]. Changes in factors related to glucose and lipid metabolism were assessed after the three-month study. Serum concentrations of EPA rose in EPA/DHA (+), although the levels of DHA and fasting C-peptide remained unchanged in EPA/DHA (+). In addition, there was a significant decline in the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), fasting remnant-like particles and apolipoprotein (apo) B in EPA/DHA (+), compared with the values in EPA/DHA (−). EPA/DHA-rich diet might improve glucose metabolism in elderly type 2 diabetic patients on a liquid diet. This phenomenon may be due to the improved insulin resistance mediated by the rise in serum EPA concentrations.

keywords —— arteriosclerosis; docosahexaenoic acid; eicosapentaenoic acid; fasting plasma glucose; insulin resistance

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Tohoku J. Exp. Med., 2013, 231, 63-74

Correspondence: Susumu Ogawa, M.D., Ph.D., Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

e-mail: ogawa-s@hosp.tohoku.ac.jp