Nutritional Supplements for prevention of type 2 diabetes

Diabetes is a chronic non-communicable and slowly progressing metabolic disease often involving multiple pathological mechanisms. Multiple mechanisms underlie the pathogenesis of diabetes including subclinical inflammation, glucotoxicity and lipotoxicity. Elevated levels of inflammation, particularly in the adipose tissue, is believed to be the primary trigger preceded by all of the above mentioned pathological mechanisms. Recent scientific literature established a strong link between inflammation and diabetes highlighting the role of inflammation as a primary pathological trigger for development of diabetes and its complications. Current therapies in the diabetes are unidimensional, targeted only to ameliorate the hyperglycaemic conditions. To date little or no attention has been paid to design pharmaceutical strategies to delay or modulate inflammatory pathways involved in reducing insulin secretion and/or action. Moreover current anti-diabetic medications have persistent side effects, such as body weight gain and hypoglycaemia in patients on sulphonylureas and insulin; gastrointestinal problems with metformin and acarbose; weight gain and bone fractures with thiazolidinediones; genital or urinary tract infections predominantly in females with sodium glucose co-transporter inhibitors. In the light of increasing prevalence and health costs associated with diabetes and its complications, there is a necessity for development of easy to comply strategies to modulate multiple metabolic targets with excellent long-term safety profile. In search of these agents, some bioactive compounds (nutraceuticals) aiming at prevention of diabetes through anti-inflammatory mechanisms have shown promising results. Extensive research has been carried out on anti-inflammatory and anti-hyperglycaemic potential of curcumin. Also the long chain n-3PUFA have been shown to possess lipid-lowering and anti-inflammatory properties by modulating multiple metabolic targets. We propose to evaluate the complimentary and/or synergistic effects of curcumin and/or n-3PUFA on pro-inflammatory mediators and insulin sensitivity in people with pre-diabetes. This is a 2x2 factorial, randomized, double blind, placebo controlled study. Eligible participants will be asked to consume 4 caps daily; placebo, curucmin plus placebo, omega 3 fatty acids plus placebo, curucmin and omega 3 fatty acids combination, for 12 weeks. Participants will be donating blood on the first day and post intervention along with information on 3 day food consumption, physical activity and other medications.