For Type 2 Diabetes, Fish Oil Offers No Heart Protection

If you have type 2 diabetes and take fish oil supplements to prevent heart disease, they aren't providing much help, a new study says.

The supplements - rich in healthy omega-3 fatty acids - do help cut the risk for heart attack, stroke, and other heart problems in people who don't have diabetes.

"Previous studies had suggested that fish oil supplements may have a modest benefit" for people with diabetes, says researcher Hertzel Gerstein, M.D., at McMaster University in Hamilton, Ontario, Canada. "We did not find that at all."

Nearly 26 million Americans have diabetes, either type 1 or type 2. People with diabetes who don't keep their blood sugar under control are at high risk for cardiovascular disease.

But, says Dr. Gerstein, "if you want to prevent cardiovascular disease, heart attacks, and strokes, going out and buying omega-3 fatty acids is not going to do it."

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There's no one-size-fits-all solution to living well with diabetes, but our Type 2 patient experts have these tips to share with you.

Medical Reviewer: Medical Reviewer: Gerald W. Smetana, MD Last Annual Review Date: Last Annual Review Date: August 30, 2010 © 2013 Healthgrades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades, Inc. Use of this information is governed by the Healthgrades User Agreement.

Indications and Usage for Lantus® (insulin glargine [rDNA origin] injection)

Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and children (6 years and older) with type 1 diabetes for the control of high blood sugar. It should be taken once a day at the same time each day to lower blood glucose.

Do not use Lantus® to treat diabetic ketoacidosis.

Important Safety Information for Lantus® (insulin glargine [rDNA origin] injection)

Do not take Lantus® if you are allergic to insulin or any of the inactive ingredients in Lantus®.

You must test your blood sugar levels while using insulin, such as Lantus®. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Lantus® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus® must only be used if the solution is clear and colorless with no particles visible. Do not share needles, insulin pens or syringes with others.

The most common side effect of insulin, including Lantus®, is low blood sugar (hypoglycemia), which may be serious. Some people may experience symptoms such as shaking, sweating, fast heartbeat, and blurred vision. Severe hypoglycemia may be serious and life threatening. It may cause harm to your heart or brain. Other possible side effects may include injection site reactions, including changes in fat tissue at the injection site, and allergic reactions, including itching and rash. In rare cases, some allergic reactions may be life threatening.

Tell your doctor about other medicines and supplements you are taking because they can change the way insulin works. Before starting Lantus®, tell your doctor about all your medical conditions including if you have liver or kidney problems, are pregnant or planning to become pregnant, or are breast-feeding or planning to breast-feed.

Lantus® SoloSTAR® is a disposable prefilled insulin pen. Please talk to your healthcare provider about proper injection technique and follow instructions in the Instruction Leaflet that accompanies the pen.

Please click here or the link below for the full prescribing information for Lantus®

High-risk group

For the study, published online this week in the New England Journal of Medicine, the researchers followed more than 12,500 people with either type 2 diabetes or prediabetes, a precursor to the disease. All were at high risk for heart attack or stroke.

The participants were randomly assigned to take either a daily supplement of omega-3 fatty acids or a placebo.

During the six-year study, the researchers looked at any causes of death among the participants. They found that taking the supplement had no effect on deaths from heart attack, stroke, other cardiovascular causes - or any other cause.

No effect on LDL cholesterol

Although the supplements did lower triglyceride levels, they did not affect levels of HDL ("good") cholesterol or LDL ("bad") cholesterol.

Spyros Mezitis, M.D., at Lenox Hill Hospital in New York City, says patients ask about whether they should take omega-3 supplements to lower cholesterol.

"We tell them that statins are drugs that are proven to lower the bad cholesterol," Dr. Mezitis says.

Some patients take fish oil on their own, he says. "We tell these patients they can continue taking fish oil, but it doesn't take the place of a statin."

Lifestyle Changes for Managing Diabetes

Because of recent medical advances, people with diabetes can do a lot more these days to help control their disease. Here are lifestyle changes you can make:

Skin. Up to a third of people with diabetes have skin disorders, such as infections. Skin self-care includes keeping your skin clean and dry. Prevent dry skin by using a moisturizing skin cream.
Oral health. People with diabetes have an increased risk for oral infections and gum problems. To help prevent gum disease, brush your teeth twice a day, floss daily, and visit your dentist at least twice a year.
Nutrition. Aim for a balanced diet low in fat, cholesterol, and sugar. Work with a nutritionist, and particularly ask for help in developing meal plans and learning how to shop for groceries.
Exercise. Physical activity improves circulation and helps you manage weight and stress levels, among other important benefits. Talk with your health care provider about choosing the best fitness options for you.
Weight. Obesity increases the body's resistance to insulin and contributes to heart disease and blood-vessel disease. Ask your doctor or nutritionist for help in finding a sensible weight-loss program.
Alcohol. Drinking alcohol makes it more difficult to control blood sugar. Alcohol can severely lower blood sugar in some people with diabetes, and it can interact with certain diabetes medications.
Stress. Physical or mental stress tends to raise levels of adrenaline and stress hormones, which can throw off your blood-sugar levels. Find ways to limit sources of stress and explore relaxation therapies.
Smoking. Smoking damages and constricts blood vessels and raises the risk for nerve damage and kidney disease.