Table 3.

Interventional studies with ω-3 PUFAs in patients with type 1 diabetes (T1D).

Study	n	Study design	Results
Stene and Joner et al. (49)	545 subjects with childhood-onset T1D	Daily supplements with 5 mL of cod liver oil (0.6 g DHA, 0.4 g EPA, and 10 μg vitamin D) in the first year of life.	Significantly lower risk of type 1 diabetes in the first year of life with supplements of cod liver oil.
Norris et al. (50)	1770 children at increased risk for T1D	A longitudinal, observational study of children at increased risk for type1 diabetes with dietary intake of PUFAs (~150 mg/day EPA+DHA) started at age 1 yearThe mean age at follow-up was 6.2 years.	EPA/DHA supplement starting from the first year of life sharply lowered the incidence of islet autoimmunity and the titers of autoantibodies in children with a high risk of T1D.
Cadario et al. (51)	2 cases of T1D in pediatric subjects after a short clinical history of classic symptoms of overt disease	Supplements of vitamin D (1,000 IU/day) started just at the discharge and ω-3 (EPA + DHA 50–60 mg/kg/day, EnerZona®ω-3).	Improved blood glucose control and progressively reduced in relation to blood glucose eat awakening. A small amount of basal insulin at bedtime was maintained. Vitamin D and ω-3 supplementation may represent a cost-effective strategy in T1D.
Chase et al. (52)	Beginning either in the last trimester of pregnancy (41 infants) or in the first 5 months after birth (57 infants). Infants had a first-degree relative with T1D	Mothers received DHA (800 mg/day) or corn/soy oil (800 mg/day) in the last trimester of pregnancy and continued on this same dose after delivery if breast-feeding. Formula-fed infants received formula with 10.2 mg DHA/ounce (treatment) or 3.4 mg DHA/ounce (control).	The levels of RBC DHA increased in treated infants. No statistically significant reductions in the production of the inflammatory cytokines. Reduced hsCRP level in breast-fed DHA-treated infants.

PUFAs, Polyunsaturated fatty acids; T1D, Type1 diabetes; DHA, Docosahexaenoic acid; EPA, Eicosapentaenoic acid; hsCRP, high-sensitivity C -reactive protein.