Omega-3 Fatty Acids Supplementation Improves Early-stage Diabetic Nephropathy and Subclinical Atherosclerosis in Pediatric Patients With Type 1 Diabetes

Inclusion Criteria: * patients with T1DM on regular insulin therapy. * age from 12 to 18 years. * disease duration at least 5 years. * having diabetic nephropathy in the form of microalbuminuria (urinary albumin excretion \[UAE\] 30-299 mg/g creatinine). * hemoglobin A1c (HbA1c) ≤8.5% (69 mmol/mol). * persistent microalbuminuria was confirmed by abnormal two or three urine samples over a 3- to 6-months period prior to the study despite angiotensin converting enzyme inhibitors (ACE-Is) Exclusion Criteria: * patients with any clinical evidence of infection. * patients with renal impairment due to causes other than diabetes. * other diabetic complications than nephropathy. * elevated liver enzymes. * hyper- or hypo-thyroidism. * intake of any vitamins or food supplements one month before study. * participation in a previous investigational drug study within the three months preceding screening.