Doubt cast on diabetes assumptions

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A breakthrough discovery has cast doubt on previous assumptions that glucose is the main driving force behind chronic inflammation within type 2 diabetes.

University of Kentucky researchers carried out a study to test whether glucose is the cause of chronic inflammation - previously it has been assumed that raised blood glucose levels is the cause.

Their investigations indicate that an interaction between certain lipids (blood fats) and mitochondria (the powerhouse of cells in the body) appeared to be the problem.

Blood glucose control is still important for managing type 2 diabetes, but the researchers state it may not be the key factor in the development of problems related to inflammation such as heart and kidney disease.

Originally the researchers had set out to prove another theory: that immune cells from people with type 2 diabetes would produce energy by burning glucose.

"We were wrong," said Barbara Nikolajczyk, from the UK Barnstable Brown Diabetes Center, Department of Pharmacology and Nutritional Sciences, who co-led the study.

The researchers found instead that energy from glucose was not driving chronic inflammation, but rather it was a combination of defects in mitochondria and an increase in fat derivatives that were responsible.

"Our data provide an explanation for why people with tight glucose control can nonetheless have disease progression."

Nikolajczyk and colleagues now plan to precisely identify which types of fatty derivatives are linked with inflammation and to investigate associations between lipids and insulin resistance

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  • Posted Omega 3 from algae or fish or supplements with it in is very important for inflamation reduction. We probably evolved mainly near the sea and all our cells need it for optimum function. It's also important for brain development. We can convert Omega 3 from things like nuts to this form, but not very efficiently.

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    • Posted

      Anne, I agree, balancing omega-3 and omega-6, especially epa and dha rather than the ala in nuts, is very important - for everyone, not just diabetics!

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    • Posted

      This was published last year

      For many

      years, I suggested that my cardiology patients take fish oil supplements as an

      easy way of getting heart-healthy omega 3 fatty acids.


      rethinking that advice. Here's why.

      About one in

      five American adults takes fish oil capsules, often because they have been told

      it can help prevent a heart attack or even treat coronary artery disease.

      People also take it for other reasons, such as arthritis and depression.

      Eating enough fish is hard to do, so my advice has always been to take the pill

      and get the same benefits.

      But science

      has me doubting this wisdom. Two recent studies, both of which examine all of

      the available data about the effects of fish oil – and there are a lot — suggest

      there is no advantage, except possibly to the makers of the pills.

      One study, published in the journal Circulation reinforces the idea that fish oil, when taken

      by people without heart disease, did not change the risk of having a heart

      attack, stroke or heart failure

      The second

      study In Jama Cardiology went even further. Published earlier this year,

      this meta-analysis (a review of all large fish oil trials done to date)

      showed no payback of any kind in preventing heart attacks, strokes, or heart-disease-related

      death in the more than 77,000 high-cardiac-risk individuals who participated in

      10 large clinical trials.

      There is no

      doubt that eating actual fish once or twice a week, especially the

      "oily" kinds of fish rich in omega 3 fatty acids called DHA and EPA,

      is associated with a lower risk of dying from a heart problem. Fried fish,

      alas, does not count, because deep-frying anything poses its own health risks.

      So how did so

      many cardiologists and patients fall for fish oil supplements?

      Early fish oil

      studies strongly suggested a cardiac benefit of supplements. For example,

      the GISSI PREVENZIONE Trial 10 percent reduced risk of having a heart attack in

      patients who took omega 3 fatty acid capsules, compared with a group of people

      who did not. But, the results of recent, larger and better-designed

      trials have been more equivocal.

      Bottom line: Without

      evidence that they prevent heart attacks in those with no history of heart

      disease, or prevent further problems in high-risk individuals, it is hard to

      support the routine use of this supplement.

      If you have both high

      triglyceride levels and heart disease, these supplements will lower

      triglyceride levels. Though it's not proven that doing so will extend life, for

      these people the supplements might make sense.

      In view of all this, here

      are my recommendations:

      There are several

      prescription fish oils. Some are now generic, have the advantage of

      being approved by the U.S. Food and Drug Administration, are rich in DHA

      and EPA, and are purified. They are often not covered by many

      prescription plans and can be expensive. If you are going to continue fish oil

      supplementation, this is the ideal kind to take.

      Over-the-counter fish oils

      are not regulated by the FDA and may not be filtered for heavy metals such

      as mercury.

      Studies are ongoing to

      see whether high-risk patients with high triglycerides and low HDL (good)

      cholesterol will live longer if they take omega 3 fatty acids.

      If you do not have a heart

      problem, and are taking fish oil to prevent one, I would suggest stopping it.

      If you have had a heart

      attack or other heart problem, are on other medications such as statins

      that decrease future risk, have normal triglyceride levels, and are taking a

      fish oil supplement, there is no proof that it helps, but is possible

      that it has a small effect.

      It is a popular

      misconception that taking fish oil will help lower your cholesterol. It will

      not, but instead can actually raise your LDL (bad) cholesterol levels.

      Side effects from omega 3

      fatty acids can include burping up a fishy taste, stomach distress, and


      Most of us probably do not

      need these supplements, and the side effects and cost likely outweigh any

      advantages. As I have believed strongly in the beneficial effects of

      omega 3 fatty acid for many years, I find this to be a painful conclusion. But

      in medicine, it is important to follow the evidence, and right now the sum of

      all these trials suggests that this popular item should be left on the shelf.

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    • Posted

      Derek, talk to any nutritionist, as apparently medical doctors are required to be entirely ignorant of the most basic facts.

      You cannot just drop in a few fish oil capsules and expect to see results, unless omega-6 is also controlled. It is a matter of balance and perhaps also total consumption. Omega-3 is not just magic.

      I got into this long ago for inflammation purposes, and for auto-immune diseases I think you can see results in simple trials over a period of weeks. OTOH I do not have such a study handy. Nor one that attempted this and failed to see results.

      Almost all fish oil sold today is molecularly distilled, and for 10% more you get the odorless kind. For a few bucks more you get more EPA, which is perhaps favored over DHA, although the science is not in whether you're better off with one or both.

      Again, I don't know that this has any direct bearing on diabetes, except of course when challenged by diabetes fixing any other health and diet issues may be increasingly important.

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    • Posted

      Fish oils would seem to be a natural thing and we were all brought up (I'm 85 )on cod liver oil and it was even provided for kids at our schools along with concentrated orange juice during the war. Now it has got out of hand and every obscure vegetable. plant and mineral is boosted as a health aid including shark fins. The Chinese are even more into it with tiger bones and tiger balm and other animal products. Here the BBC programme Trust Me I'm a Doctor checked hundreds of health supplements from seemingly reputable outlets and found many did not contain the amounts stated and some none of it at all. People talk about Big Pharma but Big Supplement is even worse.

      A few years ago herbalists had regulations put into force making tests compulsory on their products. Homeopathy has been a big sufferer with NHS support practically withdrawn.

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