Diabetes and Omega-3
When it comes to diabetes and omega-3s, the two do and do not get along together really well. It is like a fifty-fifty situation. The inference contained in this article is “better be safe than sorry.” Because of the conflicting shreds of evidence regarding the use of omega 3 fatty acids in Diabetes, it is better to consult your doctor before considering to supplementing omega-3s or fish oils in your diet if you are a diabetic.
Omega-3 Fatty acids
First, let us look at what exactly are omega-3s. Omega-3 Fatty acids are long-chain polyunsaturated, essential fatty acids (i.e. You have to obtain them from your diet, owing to the fact that they are not synthesized in your body). The two crucial omega-3 Fatty acids include EPA and DHA.
Vital Sources of Omega-3
Fish oils and krill oil offer the most abundant supply of omega 3s. Krill are small crustaceans. Other sources of omega 3s (ALA) are nuts like walnuts and flaxseeds.
Are Omega-3s Good or Bad for Diabetes? Factors which Oppose the Use of Omega-3s in Diabetes
The consumption of these fatty acids in Diabetes is controversial, where they have shown to increase, rather than decrease the blood glucose levels when consumed in excessive amounts, particularly in patients with type 1 insulin-dependent Diabetes (6). The Mayo Clinic reports similar results concerning omega-3 use in diabetes. Furthermore, the omega-3s have shown a tendency to raise the LDL-C (the cholesterol content within the LDL i.e. bad cholesterol particles) levels.
Factors which Favor the Use of Omega-3s in Diabetes
Nonetheless, a few other types of researches show beneficial effects of omega-3s in Diabetes.
1) Since the diabetics have high triglyceride and low HDL levels, and the risk of coronary heart disease in Diabetes is considerably greater than in the general population (three-to fourfold). The omega-3s are not only significant in lowering the blood triglyceride and raising theHDL levels, and thereby preventing cardiovascular diseases like angina and heart attacks (by inhibiting platelet aggregation and the plaque accumulation). On top of that, they also reduce the apolipoproteins (the markers of diabetes).
2) A by-product of omega-3s, namely protectin DX triggers the release of a cytokine called IL-6, which in turn diminishes the glucose production by the liver, thereby, lowering the blood glucose levels.
3) Given that Diabetes also augments the atherosclerosis-related inflammation (5) and omega-3s serve as powerful anti-inflammatory substances, this fact also somehow supports the use of omega-3s in diabetes.
4) Excerpts from a study showed no significant harmful effects of omega-3s in patients with type 2 diabetes (7).
So how can Diabetics Acquire the Beneficial Effects of Omega-3s without incurring more Harm?
Against all this background, the utilization of omega-3s in diabetes should be considered vigilantly. As claimed by the FDA, doses up to 3 grams/day of n-3 PUFatty acids (polyunsaturated fatty acids) are safe in diabetes, provided the patient does not have an already raised LDL cholesterol level. If considering a dietary supplement, FDA recommends using no more than 2 grams/day of ω-3 fatty acids. It is sufficient to consume a moderate quantity. Aim for a minimum of 250 mg to a max of 2,000 grams and you will be good to go! If you have high triglycerides and low HDL, omega-3s are your best buddy. However, always be wary that high doses apart from deteriorating the blood glucose and LDL levels might also lead to other health concerns like mercury and vitamin A toxicity.
FYI, contrary to the popular belief, omega-3s do not increase the risk of bleeding during surgery. However, since they increase the bleeding time, it is better to consume them in moderate amounts.
What do the Omega-3s specifically do?
Well, it turns out that our cell membranes made up of two lipid layers (lipid=fat), called phospholipid bilayer membrane makes it easier for these EPA and DHA to incorporate into this lipid bilayer.
The omega-3s not only have potent anti-inflammatory effects (as mentioned below), yet they also tell another group of omega fatty acids, called omega-6 to “get out of their way” in order to gain entrance into the cell membrane. There is a culprit in the omega-6 group, called arachidonic acid (AA). This AA serves as a smoking gun behind all types of inflammation and atherosclerosis (a process typified by the build-up of fatty plaques within the arterial walls and hardening of the arteries).
When activated, AA stimulates two metabolic pathways, called cycloxygenase and lipoxygenase pathways. These enzyme pathways contribute to the production of even more destructive inflammatory mediators, called prostaglandins, leukotrienes, and thromboxane (some of these like thromboxane A2 also predispose to platelet aggregation and atherosclerosis). Aggregation or clumping of blood cells called platelets predisposes to the formation of the blood clot that is a major precursor to atherosclerosis, angina, MI, and stroke.
As is obvious from the above description, the omega-3s acquired from the diet displace the omega-6 family, including AA, via competing with it and kicking it off, and therefore, they possess a strong potential to inhibit the inflammation, platelet aggregation and subsequent atherosclerosis.
What’s more, the omega-3s also accelerate the membrane fluidity, thereby allowing cells to communicate with each other more efficiently and easing the entry of other substances through the cell membrane into the cell.
1) PubMed.gov (US National Library of Medicine)
4) Jama.JAMAnetwork.com/article.aspx?articleid=188459: The Journal of The American Medical Association
8) en.m.Wikipedia.org/wiki/Diabetes mellitus