| Outcome Measures: |
Primary: Change from baseline of omega-3 index at 16 and 24 weeks, The omega-3 index is defined as defined as the sum of EPA and DHA, as a percentage of total fatty acids in red blood cells. Red blood cells will be isolated by centrifugation and subsequently analyzed for fatty acid composition following folch extraction of the lipids, derivatization and analysis of the fatty acid profile by gas liquid chromatography. These studies will be done in Dr. Yorek's laboratory., At baseline, 16 weeks and 24 weeks. | Secondary: Change in baseline of serum levels of resolvin D1, resolvin E1 and neuroprotectin D1, omega-3 polyunsaturated fatty acid metabolites, at 16 and 32 weeks., Anti-inflammatory mediators, resolvin D1, resolvin E1 and neuroprotectin D1 will be determined using liquid chromatography with tandem mass spectrometry (LC-MS/MS) and authentic standards. Blood will be collected in EDTA/butylated hydroxytoluene/reduced glutathione (EDTA/BHT/GSH) to stabilize lipid mediators by minimizing peroxidation allowing for safe storage at -80C. They will then be analyzed in batches. Results will be reported as pg/ml serum., At baseline, 16 weeks and 24 weeks.|Changes from baseline of serum levels of C reactive protein at 16 and 24 weeks., A commercial ELISA kit will be used for analysis of C reactive protein in the laboratory of Dr. Yorek at the University of Iowa., At baseline, 16 weeks and 24 weeks.|Changes from baseline of serum levels of tumor necrosis factor α at 16 and 24 weeks., A commercial ELISA kit will be used for analysis of C tumor necrosis factor α in the laboratory of Dr. Yorek at the University of Iowa., At baseline, 16 weeks and 24 weeks.|Changes from baseline of serum levels of interleukin 6 at 16 and 24 weeks., A commercial ELISA kit will be used for analysis of analyzed interleukins 6 in the laboratory of Dr. Yorek at the University of Iowa., At baseline, 16 weeks and 24 weeks.|Changes from baseline of serum levels of interleukin 10 at 16 and 24 weeks., A commercial ELISA kit will be used for analysis of protein interleukins 10 in the laboratory of Dr. Yorek at the University of Iowa., At baseline, 16 weeks and 24 weeks.|Change from baseline in the ratio of omega-6 and omega-3 fatty acids in serum at 16 and 24 weeks, Serum will be folch extracted and fatty acid composition determined following derivatization and analysis by gas-liquid chromatography., At baseline, 16 weeks and 24 weeks.|Change from baseline in diabetic peripheral neuropathy symptoms score after 24 weeks using the Michigan Neuropathy Screening Instrument., Complete the Michigan Neuropathy Screening Instrument questionnaire. The first part of the screening instrument, the history questionnaire, consists of 15 self-administered "yes or no" questions on foot sensation including pain, numbness and temperature sensitivity. A higher score (out of a maximum of 13 points) indicates more neuropathic symptoms. The minimum score is 1 and maximum score 13., At baseline and 24 weeks.|Change from baseline of vibration perception after 24 weeks., Vibration perception threshold (a marker of DPN) will be tested using a 128 Hz tuning fork placed over the dorsum of the great toe on the boney prominence of the distal interphalangeal joint of both feet and scored as either present/reduced/absent., At baseline and 24 weeks.|Change from baseline of ankle reflex after 24 weeks., Ankle reflex (a marker of DPN) will be tested bilaterally and scored as present/present with reinforcement/absent., At baseline and 24 weeks.|Pin prick evaluation, This determination is part of the Utah early neuropathy scale. Pin sensation is tested by determining the sensation of a sharp pin along six points from the great toe to the knee. The subject's eyes are closed and they are asked if they feel any sharpness. Scoring is 0 for normal sensation, 1 for reduced sensation and 2 for absent sensation. The higher the score the worse the neuropathy., At baseline and 24 weeks|Change from baseline in fasting blood glucose after 16 and 24 weeks., Blood glucose will be determined using an Accu Chek blood glucose monitor., At baseline, 16 weeks, and 24 weeks.|Change from baseline in fasting insulin levels after 16 and 24., Determination will be done by the hospital pathology laboratory., At baseline, 16 weeks, and 24 weeks.|Change from baseline in hemoglobin A1C after 16 and 24 weeks., Determination will be done by the hospital pathology laboratory., At baseline, 16 weeks and 24 weeks.|Change from baseline in fasting blood lipids (triglycerides and low- and high-density cholesterol) after 16 and 24 weeks., Determination will be done by the hospital pathology laboratory., At baseline, 16 weeks and 24 weeks.|Change from baseline in urine microalbuminuria levels after 16 and 24 weeks., Determination will be done by the hospital pathology laboratory., At baseline, 16 weeks and 24 weeks.
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