Fatty acids, insulin resistance and diabetes

Abstract

Recent data strongly suggest that atherosclerosis progression may be slowed by increased intakes of essential fatty acids (EFAs) from fish even in diabetes. The current evidence also indicates the potential benefits of EFAs on atrial fibrillation, particularly in the immediate post-cardiac surgery setting. EFAs also appear to reduce risk for arrhythmias and fatal coronary heart disease (CHD) events. Despite a growing body of research on the benefit of essential fatty acids (monounsaturated fatty acids [MUFAs] and polyunsaturated fatty acids [PUFAs]) for cholesterol lowering in CHD, there are insufficient outcome data on the use of EFAs on glycemic control as well as inadequate data to show the efficacy on insulin resistance and diabetes. The focus of this chapter is to discuss different fatty acids and therapeutic approaches toward treating insulin resistance syndrome (IRS) and diabetes exclusively by lowering cholesterol levels and glucose control as a medical nutrition therapy. Although results of epidemiologic studies as well as clinical trials and clinical end points confirm the association of (omega-3) fatty acids and MUFAs with cholesterol lowering, lowering inflammatory markers and risk of CHD, data are lacking regarding the effects of these fatty acids in the management of diabetes with CHD and insulin resistance. Type 2 diabetes mellitus (T2DM) is found to be associated with a two-to fourfold increase in CHD risk and as the degree of association of hyperglycemia is more related to microvascular complications, correcting dyslipidemia appears to reduce macro vascular events in patients with T2DM. Future dietary management strategies are required for the use of essential fatty acids in the management of insulin resistance and diabetes. © 2008 Humana Press Inc.