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Effects of Different Fish Oil Types on Type 2 Diabetes Risk Factors in High-Risk Adults (END-T2D)

8 maj 2026 uppdaterad av: May Faraj, PDt, PhD

Role of EPA and DHA as Tailored Therapy for People Living With Obesity and High-risk for Type 2 Diabetes (END-T2D): a Randomized Controlled Trial

The purpose of this clinical trial is to find out whether one type of fish oil works better than another at improving metabolic health in people who are at high risk of developing type 2 diabetes.

Some metabolic problems-such as difficulty controlling blood sugar, unhealthy particles that transport cholesterol in the blood, and poor fat tissue function-can increase the risk of type 2 diabetes. This study aims to determine whether different types of fish oil can:

  1. Improve how well the body produces insulin and responds to it,
  2. Improve the quality of the particles that carry "bad" cholesterol in the blood, and 3) Improve the health and function of participants' fat tissue.

To answer these questions, researchers will compare the effects of two types of fish oil: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These will be compared with corn oil, which is used as a placebo and does not contain EPA or DHA.

When included in this study, participants will:

A) Take softgel capsules containing EPA, DHA, or placebo (corn oil) every day for 12 weeks, B) Keep a daily log to record when they take their study softgels, and C) Visit the research unit six times, including one and a half days before and after the intervention, to complete specialized metabolic tests that are mostly only available in research settings.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Background and Rationale:

According to the International Diabetes Federation, about 590 million adults worldwide-or 1 in 9 adults-were living with diabetes in 2025, most of whom had type 2 diabetes (T2D). An additional 230 million adults (about 4 in 10) are unaware that they have diabetes and therefore remain undiagnosed. Diabetes substantially increases the risk of illness and death and has an impact comparable to aging approximately 15 years, making it a leading cause of disability and mortality worldwide.

Type 2 diabetes develops gradually as multiple risk factors accumulate over time, including unhealthy lifestyle habits and aging. These factors reduce the body's ability to produce insulin and/or respond effectively to insulin, a hormone that regulates blood sugar levels. As a result, blood sugar levels progressively rise and may eventually lead to a diagnosis of T2D.

Importantly, type 2 diabetes is preventable.

In people with T2D, elevated blood levels of apolipoprotein B (apoB) increase the risk of cardiovascular disease (apoB is a measure of the number of particles that carry "bad" cholesterol known as low density lipoproteins (LDL)). Traditionally, high apoB levels were considered a consequence of T2D. However, research from the principal investigator's laboratory has shown that high apoB levels may also contribute to the development of T2D.

This appears to occur because LDL particles can promote inflammation and impair the normal function of fat tissue. Poorly functioning fat tissue is associated with multiple metabolic abnormalities that increase the risk of both T2D and cardiovascular disease. Large population based studies confirmed that elevated blood apoB levels can predict the development of T2D many years before diagnosis.

Recent findings from the research team also indicate that 12 week supplementation with marine derived omega 3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), can improve several risk factors for T2D, particularly in individuals with higher blood apoB levels. However, these data suggest that EPA and DHA may not provide identical benefits in reducing these risk factors.

Study Objective:

The overall aim of this study is to compare the effects of EPA versus DHA on major risk factors for T2D in adults with overweight or obesity and elevated blood apoB levels.

Study Design and Procedures:

After eligibility is confirmed, participants will visit the research institute (IRCM) for two baseline visits scheduled one week apart. During these visits, investigators will used specialized metabolic testing to:

  1. Assess how participants' bodies process glucose and produce insulin using blood samples, and
  2. Examine how participants' fat tissue responds to their own LDL using a small fat tissue biopsy.

Participants will then be randomly assigned to follow one of three interventions for 12 weeks: EPA, DHA or corn oil (placebo). At the end of the 12 week intervention, participants will return to the research institute to undergo the same assessments performed at baseline.

Data Analysis:

At the conclusion of the study, results from participants in each intervention group (EPA, DHA, and placebo) will be averaged and compared. This will allow researchers to determine the effects of EPA and DHA on key risk factors for T2D and to evaluate whether one omega 3 fatty acid is more effective than the other.

Studietyp

Interventionell

Inskrivning (Beräknad)

84

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

  • Kanada
    • Quebec
      • Montreal, Quebec, Kanada, H2W 1R7
        • Institut de recherches cliniques de Montréal (IRCM)
        • Kontakt:
        • Huvudutredare:
          • May Faraj, P.Dt., Ph.D.
        • Underutredare:
          • Study physician: Remi Rabasa-Lhoret, M.D., Ph.D.

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Beskrivning

Inclusion Criteria:

Males and post-menopausal females:

  • With a body mass index (BMI >25-40 kg/m2)
  • Having confirmed menopausal status (FSH ≥ 30 U/l)
  • Non-smokers (tobacco) or have quitted for over a year
  • Low-moderate alcohol consumption: <7 alcoholic servings/ week
  • Plasma apoB ≥1.05 g/L

Exclusion Criteria:

  • Elevated risk of cardiovascular disease (≥ 20% of calculated Framingham Risk Score)
  • Prior history of cardiovascular events (e.g. stroke, transient ischemic attack, myocardial infarction, angina, heart failure, arrhythmias, flutter, atrial …)
  • Systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg
  • Diabetes or HbA1c ≥ 6.5%
  • Reactive hypoglycaemia
  • Prior history of cancer within the last 3 years or if lymph nodes were removed
  • Thyroid disease - untreated or unstable Synthroid dose
  • Severe renal dysfunction - eGFR < 30 mL/min/1.73 m²
  • Hepatic dysfunction - AST/ALT > 3 times normal limit
  • Anemia - Hb < 120 g/L in females and < 130 in males
  • Bleeding disorders
  • Blood coagulation problems (i.e. bleeding predisposition)
  • Malabsorptive disease or surgeries (e.g. bariatric surgeries)
  • Autoimmune and chronic inflammatory disease (i.e. celiac, inflammatory bowel, Graves, multiple sclerosis, psoriasis, rheumatoid arthritis, and lupus).
  • Chronic diarrhea
  • Cholecystectomy (e.g. removal of gall bladder)
  • Sleep apnea
  • Seizures
  • Known history of difficulties accessing a vein
  • Known history of vagal shock or loss of consciousness during blood withdrawal
  • Concomitant medications (systemic corticosteroids; hypertension medication; anti-psychotic medications - psycho-active medication that promote weight gain; anticoagulant or anti-aggregates treatment (e.g. aspirin, NSAIDs, warfarin, coumadin..); systemic adrenergic agonists; weight-loss medication (e.g. GLP-1 agonists); lipid lowering medication (e.g. statins, anti-PCSK9); )
  • Allergy to seafood/fish or corn oil
  • Allergy to bovine gelatine or glycerine (softgel components)
  • Allergy to Xylocaine (anesthesia used during fat tissue biopsy)
  • Anticipated surgery or blood transfusion
  • Known substance abuse
  • Very high physical activity (> 5 hours of aerobic exercise per week)
  • Already taking more than 1 gm of EPA and/or DHA supplementation per day
  • Lack of compliance to the study requirements (i.e. not being fasting)
  • Cancellation of the same scheduled testing visit more than once
  • Lack of time to participate in the full length of the study (18-22 weeks)
  • Other conditions deemed inappropriate by the study physician (e.g. difficulties in understanding/communicating in French or English)

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Eicosapentaenoic acid (EPA)
4 g EPA per day
Kosttillskott: Fish Oil
Four softgels of Carlson Elite EPA Gems taken orally per day (NPN 80079735, 1 g EPA/softgel)
Kosttillskott: Fish Oil
Four softgels of Carlson Elite DHA Gems taken orally per day (NPN 80079736, 1 g DHA/softgel)
Aktiv komparator: Docosahexaenoic acid (DHA)
4 g DHA per day
Kosttillskott: Fish Oil
Four softgels of Carlson Elite EPA Gems taken orally per day (NPN 80079735, 1 g EPA/softgel)
Kosttillskott: Fish Oil
Four softgels of Carlson Elite DHA Gems taken orally per day (NPN 80079736, 1 g DHA/softgel)
Placebo-jämförare: Corn oil
0 g EPA and DHA per day
Kosttillskott: Corn oil control
Four softgels of Carlson placebo taken orally per day (food-grade corn oil, 0 g EPA and DHA per softgel)

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change from baseline to 12 weeks in the disposition index
Tidsram: 12-weeks
Disposition index calculated as first phase glucose-induced insulin secretion multiplied by insulin sensitivity measured during the Botnia clamp [(ng C-peptide/mL)*(mg dextrose/kg/min)/(µU insulin/mL)]
12-weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change from baseline to 12 weeks in glucose-induced insulin secretion
Tidsram: 12 weeks
Glucose-induced insulin secretion measured by the Botnia clamp (ng C-peptide/mL)
12 weeks
Change from baseline to 12 weeks in insulin sensitivity
Tidsram: 12 weeks
Insulin sensitivity measured by the Botnia clamp (mg dextrose/kg/min)/(uU insulin/mL)
12 weeks
Change from baseline to 12 weeks in the oral disposition index
Tidsram: 12 week
Oral disposition index calculated as insulin secretion index (0-30 min) multiplied by insulin sensitivity index measured during an oral glucose tolerance test (arbitrary unit)
12 week
Change from baseline to 12 weeks in low-density lipoprotein (LDL) size
Tidsram: 12 weeks
LDL size measured by Quantimetrix Lipoprint System (Å)
12 weeks
Change from baseline to 12 weeks in LDL-induced white adipose tissue (WAT) inflammation
Tidsram: 12 weeks
LDL-induced WAT inflammation measured as WAT gene expression of a panel of pro- and anti-inflammatory mediators/markers (e.g. NLRP3, IL1B, MCP1, IL10, TREMs) by RT-qPCR. This will be measured after the incubation of participant WAT biopsies without or with their own LDL ex vivo.
12 weeks

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change from baseline to 12 weeks in LDL-induced WAT inflammation
Tidsram: 12 weeks
LDL-induced WAT inflammation measured as WAT secretion of a panel of pro- and anti-inflammatory mediators/markers (e.g. IL-1β, MCP1, IL10) by multiplex. This will be measured after the incubation of participant WAT biopsies without or with their own LDL ex vivo.
12 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

May Faraj, PDt, PhD

Samarbetspartners

Diabetes Canada

Utredare

  • Huvudutredare: May Faraj, P.Dt., Ph.D., Institut de recherches cliniques de Montréal (IRCM)/ Université de Montréal

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 juli 2026

Primärt slutförande (Beräknad)

1 december 2029

Avslutad studie (Beräknad)

1 december 2029

Studieregistreringsdatum

Först inskickad

4 maj 2026

Först inskickad som uppfyllde QC-kriterierna

4 maj 2026

Första postat (Faktisk)

8 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

12 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

8 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2026-1363
  • Award ID: EDA-25-1514974 (Annat bidrag/finansieringsnummer: Diabetes Canada)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

Frozen plasma and white adipose tissue samples (when available in sufficient quantity) may be shared with other investigators for analysis. However, all statistical analyses incorporating the complete participant data will be conducted exclusively by the IRCM research team, in accordance with the Information and Consent Form signed by the participants

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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