Effect of omega-3 supplementation on neuropathy in type 1 diabetes: A 12-month pilot trial

Neurology. 2017 Jun 13;88(24):2294-2301. doi: 10.1212/WNL.0000000000004033. Epub 2017 May 17.

Abstract

Objective: To test the hypothesis that 12 months of seal oil omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation will stop the known progression of diabetic sensorimotor polyneuropathy (DSP) in type 1 diabetes mellitus (T1DM).

Methods: Individuals with T1DM and evidence of DSP as determined by a Toronto Clinical Neuropathy Score ≥1 were recruited to participate in a single-arm, open-label trial of seal oil ω-3 PUFA supplementation (10 mL·d-1; 750 mg eicosapentaenoic acid, 560 mg docosapentaenoic acid, and 1,020 mg docosahexaenoic acid) for 1 year. The primary outcome was the 1-year change in corneal nerve fiber length (CNFL) measured by in vivo corneal confocal microscopy, with sensory and nerve conduction measures as secondary outcomes.

Results: Forty participants (53% female), aged 48 ± 14 years, body mass index 28.1 ± 5.8 with diabetes duration of 27 ± 18 years, were enrolled. At baseline, 23 participants had clinical DSP and 17 did not. Baseline CNFL was 8.3 ± 2.9 mm/mm2 and increased 29% to 10.1 ± 3.7 mm/mm2 (p = 0.002) after 12 months of supplementation. There was no change in nerve conduction or sensory function.

Conclusions: Twelve months of ω-3 supplementation was associated with increase in CNFL in T1DM.

Clinicaltrialsgovidentifier: NCT02034266.

Classification of evidence: This study provides Class IV evidence that for patients with T1DM and evidence of DSP, 12 months of seal oil omega-3 supplementation increases CNFL.

Publication types

  • Clinical Trial

MeSH terms

  • Animals
  • Canada
  • Diabetes Mellitus, Type 1 / diet therapy*
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Neuropathies / diet therapy*
  • Diabetic Neuropathies / pathology
  • Diabetic Neuropathies / physiopathology
  • Dietary Supplements*
  • Docosahexaenoic Acids / administration & dosage
  • Eicosapentaenoic Acid / administration & dosage
  • Fatty Acids, Omega-3 / administration & dosage*
  • Fatty Acids, Unsaturated / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Oils
  • Pilot Projects
  • Seals, Earless
  • Treatment Outcome

Substances

  • Fatty Acids, Omega-3
  • Fatty Acids, Unsaturated
  • Oils
  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid
  • docosapentaenoic acid

Associated data

  • ClinicalTrials.gov/NCT02034266