ESPE Abstracts

Background: Numerous studies have evaluated the beneficial effects of omega-3 fatty acids on inflammatory, autoimmune and renal diseases. However, data about the effects of omega-3 fatty acids on diabetic kidney disease in type 1 diabetes mellitus (T1DM) are lacking.

Objectives: This randomized-controlled trial assessed the effect of oral omega-3 supplementation on glycemic control, lipid profile, albuminuria level, kidney injury molecule-1 (KIM-1) and carotid intima media thickness (CIMT) as a surrogate marker for subclinical atherosclerosis in children and adolescents with T1DM and diabetic nephropathy.

Methods: Seventy T1DM patients and diabetic nephropathy were enrolled with a mean age 15.2 ± 1.96 years and median disease duration 7 years. Patients were randomly assigned into two groups; intervention group which received oral omega-3 fatty acids capsules (1 gram daily). The other group received a matching placebo and served as a control group. Both groups were followed-up for 6 months with assessment of fasting blood glucose (FBG), HbA1c, fasting lipids, urinary albumin creatinine ratio (UACR), KIM-1 and CIMT.

Results: Both groups were well-matched as regards baseline clinical characteristics and laboratory parameters (P>0.05). After 6 months, omega-3 fatty acids adjuvant therapy for the intervention group resulted in a significant decrease in FBG, HbA1c, triglycerides, total cholesterol, LDL-cholesterol, UACR, KIM-1 and CIMT, whereas, HDL-cholesterol was significantly higher post-therapy compared with baseline levels and compared with the control group (P<0.05). Baseline KIM-1 levels were positively correlated to HbA1c% (r= 0.589, P<0.001), UACR (r= 0.647; P<0.001) and CIMT (r= 0.612; P<0.001). Supplementation with omega-3 fatty acids was safe and well-tolerated.

Conclusions: Omega-3 fatty acids as an adjuvant therapy in pediatric T1DM patients with diabetic nephropathy improved glycemic control, dyslipidemia, prevented disease progression and subclinical atherosclerosis among those patients.