Polyunsaturated fatty acids and type 2 diabetes: Impact on the glycemic control mechanism

Abstract

There is a growing mortality related to co-morbidities associated with diabetes mellitus. Intake of polyunsaturated fatty acids (PUFA) has been associated with low cardiometabolic risk and reduction of inflammatory process. The objective of this paper is to review the impact of PUFA intake on glycemic control in diabetic patients as well as to elucidate the possible mechanisms involved. Medline/PubMed electronic database was searched to identify studies published within last five years regarding the effect of PUFA intake on glucose metabolism in type 2 diabetics. The search terms used were "polyunsaturated fatty acid(s)," "PUFA," and "diabetes." We included only interventional studies that assessed the effects of PUFA intake on glucose metabolism - fasting glucose, serum insulin, HbA1c, and HOMA-IR assessment- in type 2 diabetics. Initially, 48 articles were identified, of which one was not available and 41 did not match the inclusion criteria. Within the selected studies, three articles showed an improvement in fasting blood glucose, two showed an increase in fasting glycemia, and there was no effect of intervention in one article only. Based on the analyzed clinical interventional studies, supplementation of 0.42-5.2-g PUFA/day for at least eight weeks may become an alternative treatment for type 2 diabetes mellitus, particularly in Asian subjects.

Dietary α-Linolenic Acid Counters Cardioprotective Dysfunction in Diabetic Mice: Unconventional PUFA Protection

“…These metabolic factors are well-established risks for ischemic heart disease [89] and were unaltered by ALA supplementation (Figure 1). This agrees with meta-analyses indicating no effects of n-3, n-6 or total PUFA intake on T2D risk or outcomes [4,90]; although, impacts in diabetes remain contentious [34,[90][91][92][93]. On the other hand, multiple trials show substitution of saturated fatty acids with PUFAs can lower blood glucose, HbA1c, and HOMA-IR in healthy adults [94].…”

Relationship between polyunsaturated fatty acid composition in serum phospholipids, systemic low-grade inflammation, and glycemic control in patients with type 2 diabetes and atherosclerotic cardiovascular disease

“…It has been demonstrated that n-3 PUFA supplementation improved insulin sensitivity in Asian population of T2DM patients [ 30 ]. No benefits were found in Western populations [ 30 , 31 ]. This finding suggests that the favorable effect of n-3 PUFAs on insulin sensitivity may be affected by ethnicity [ 31 ].…”

“…No benefits were found in Western populations [ 30 , 31 ]. This finding suggests that the favorable effect of n-3 PUFAs on insulin sensitivity may be affected by ethnicity [ 31 ]. On the other hand, Kusunoki et al found no significant association between HOMA-IR, which was used as a marker of glycemic control, and levels of EPA, DHA, and LA in serum phospholipids of Japanese patients with T2DM [ 32 ].…”

Plasma fatty acids in de novo lipogenesis pathway are associated with diabetogenic indicators among adults: NHANES 2003–2004

“…In contrast, other studies have shown that circulating n-3 PUFA is inversely associated with insulin sensitivity in rodents (36) and type 2 diabetes (26,37). Several systematic reviews and meta-analyses focusing on dietary PUFAs and diabetogenic indicators have had inconsistent findings (38), including protective (39)(40)(41), harmful (41), and null findings (39,(41)(42)(43)(44)(45). Further studies are needed to explain these inconsistencies; one potential explanation is that dietary patterns (or combinations) of FAs may be protective against the diabetogenic state (46).…”