A NEW Cochrane review finds low-certainty evidence that omega-3 fatty acid supplements may offer little to no benefit in treating diabetic symmetrical polyneuropathy (DSPN).
Limited Support for Omega-3 in Diabetic Neuropathy
Despite biological rationale suggesting that omega-3 polyunsaturated fatty acids (PUFAs) might support nerve health, current evidence does not support their use in managing DSPN. Researchers assessed the efficacy and safety of oral omega-3 PUFA supplements in adults with Type 1 or Type 2 diabetes, or impaired glucose tolerance, and signs of DSPN. The review included two randomised controlled trials (RCTs) involving 87 participants, with intervention periods of at least six months. The primary outcome was peripheral neuropathy impairment, while secondary outcomes included symptoms, pain, quality of life, and adverse events.
Small Trials, Low-Certainty Results on Efficacy and Safety
One RCT with 43 adults with Type 1 diabetes found that omega-3 PUFA supplementation had little to no effect on peripheral neuropathy impairment after six months (relative risk: 0.24; 95% CI 0.03–1.94), or on related symptoms and health-related quality of life, though all evidence was rated as low certainty. Across two studies (78 participants), omega-3 supplements did not appear to significantly alter the risk of adverse or serious adverse events compared to placebo. However, no data were available on pain outcomes or treatment discontinuation due to adverse effects. Due to the limited sample size and methodological constraints, the certainty of the evidence was rated as low to very low using GRADE criteria.
No Clear Role Yet for Omega-3 in DSPN Treatment
Given the small number of participants and lack of robust data, the review concluded that omega-3 PUFA supplements cannot currently be recommended for the treatment or prevention of DSPN. The findings highlight the need for larger, high-quality RCTs to evaluate both potential benefits and harms in this population.
Reference
Britten-Jones AC et al. Omega‐3 fatty acid supplementation for distal symmetrical peripheral neuropathy in adults with diabetes mellitus. Cochrane Database Syst Rev. 2025;9(9):CD014623.
