We have recently demonstrated that omega-3 nutrition therapy is associated with small nerve fiber regeneration in individuals with type 1 diabetes (T1D). It is unclear if baseline omega-3s relate to the presence of diabetic sensorimotor polyneuropathy (DSP) or nerve regeneration. Forty individuals with T1D participated in a 12-month single-arm open label study of seal oil omega-3 (10 mL/d; 750 mg EPA, 560 mg DPA acid, and 1,020 mg DHA). 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. Plasma PUFAs were measured at 0, 4, 8 and 12-months. The 40 participants (53% female) had mean±SD age 48±14 years, body mass index 28.1±5.8 kg/m2, diabetes duration 27±18 years and 23(59%) had DSP. At baseline, participants with DSP had lower DHA concentration compared to those without (1.73±0.89% vs. 2.27±0.70, p=0.049). At 12-months, omega-3 nutrition therapy increased group mean plasma EPA by 185%, DPA by 29%, DHA by 79% (p<0.001) and decreased the omega-6 to omega-3 ratio by 45% (p<0.001). On average, CNFL increased 29±46% over the study, indicating small nerve fiber regeneration. This change was associated with the increase in total omega-3 (r=0.41, p=0.013), DPA (r=0.33, p=0.047) and DHA (r=0.42, p=0.012). There were 26(65%) participants that responded to therapy with a change in CNFL >0% and 9(22%) with a clinically significant loss of CNFL >-6%. At baseline, responders had higher total omega-3 (4.38±1.35% vs. 3.12±0.56%, p=0.010), EPA (0.91±0.47% vs. 0.59±0.23%, p=0.040) and DHA (2.16±0.90% vs. 1.34±0.40%, p=0.009).The change in these variables was not different between responders and non-responders (p>0.05). One year of seal oil omega-3 nutrition therapy increased blood omega-3s, while small nerve fiber regeneration appears to be related to baseline omega-3 status.


E.J.H. Lewis: Board Member; Spouse/Partner; Nutarniq Corp. Employee; Self; Nutarniq Corp. Stock/Shareholder; Self; Nutarniq Corp. B.A. Perkins: Consultant; Self; Abbott, Boehringer Ingelheim International GmbH, Insulet Corporation. Research Support; Self; Boehringer Ingelheim International GmbH, Novo Nordisk A/S. Other Relationship; Self; Medtronic. L. Lovblom: None. A. Metherel: None. T. Wolever: None. V. Bril: Advisory Panel; Self; Alexion Pharmaceuticals, Inc., Alnylam Pharmaceuticals, Takeda Canada. Consultant; Self; Akcea Therapeutics, CSL Behring, Sanofi. Research Support; Self; Biogen, Grifols, Momenta Pharmaceuticals.


Diabetes Canada (OG-2-13-4093-VB)

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