Is it time for a clinical trial of dietary fish oil supplementation in individuals with NIDDM?

In vitro experiments and in vivo studies in both animals and man have demonstrated numerous antiatherogenic effects of both increased fish consumption and fish oil supplementation in patients with non-insulin-dependent diabetes mellitus (NIDDM). However, many studies indicate that dietary fish oil supplementation, unlike increased fish consumption, has resulted in worsened glycemic control and increased LDL cholesterol levels in some individuals with NIDDM. This has led previous reviewers to suggest that intake of natural sources of dietary n-3 fatty acids should be encouraged in patients with NIDDM, but that supplementation with fish oil concentrates could not generally be recommended. The recurrent theme for the latter conclusion is the lack of sufficient data on the safety and efficacy of fish oil supplementation in NIDDM. (DBO)