Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension.
BACKGROUND
n-3 Fatty acids lower blood pressure, improve lipids, and benefit other cardiovascular disease risk factors. Effects on glycemia in patients with type 2 diabetes are uncertain.


OBJECTIVE
We determined whether purified eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have differential effects on glycemic control, including insulin sensitivity and stimulated insulin secretion; 24-h ambulatory blood pressure; and serum lipids in type 2 diabetic patients with treated hypertension.


METHODS
In a double-blind, placebo-controlled trial of parallel design, 59 subjects were randomly assigned to consume 4 g EPA, DHA, or olive oil/d for 6 wk while continuing to consume their usual diet.


RESULTS
Thirty-nine men and 12 postmenopausal women with a mean (+/- SE) age of 61.2 +/- 1.2 y completed the study. In comparison with the change from baseline in fasting glucose in the olive oil group, fasting glucose in the EPA and DHA groups increased 1.40 +/- 0.29 mmol/L (P = 0.002) and 0.98 +/- 0.29 mmol/L (P = 0.002), respectively. Neither EPA nor DHA had significant effects on glycated hemoglobin, fasting insulin or C-peptide, insulin sensitivity or secretion, or blood pressure. Serum triacylglycerols in the EPA and DHA groups decreased 19% (P = 0.022) and 15% (P = 0.022), respectively. There were no significant changes in serum total, LDL, or HDL cholesterol, although HDL(2) cholesterol in the EPA and DHA groups increased 16% (P = 0.026) and 12% (P = 0.05), respectively. HDL(3) cholesterol decreased 11% (P = 0.026) with EPA supplementation.


CONCLUSIONS
EPA and DHA had similar benefits on lipids but adverse effects on short-term glycemic control in hypertensive diabetic patients. The overall implications for cardiovascular disease require long-term evaluation.
Woodman
Richard J
RJ
Department of Medicine, The University of Western Australia, Perth, Australia. rwoodman@cyllene.uwa.edu.au
Mori
Trevor A
TA
Burke
Valerie
V
Puddey
Ian B
IB
Watts
Gerald F
GF
Beilin
Lawrence J
LJ
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D004281:Docosahexaenoic Acids / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000009:adverse effects / Q000494:pharmacology*; D005227:Fatty Acids / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007328:Insulin / Q000502:physiology; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D000069463:Olive Oil; D010743:Phospholipids / Q000097:blood; D010938:Plant Oils / Q000494:pharmacology
D001786:Blood Glucose; D005227:Fatty Acids; D007328:Insulin; D008055:Lipids; D008074:Lipoproteins; D000069463:Olive Oil; D010743:Phospholipids; D010938:Plant Oils; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid