Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

For a 62-year-old man with type 2 diabetes on high-dose fish oil, which side effect is least commonly associated with such products?

1. Decrease in HDL

2. Dyspepsia

3. Diarrhea

4. Increase in triglycerides

The correct answer is: Dyspepsia

High-dose fish oil, commonly used for its beneficial effects on cardiovascular risk and triglyceride levels, is often associated with several gastrointestinal side effects. Among these, dyspepsia, which refers to indigestion or discomfort in the upper abdomen, is indeed a recognized potential side effect. However, compared to other side effects like diarrhea, decrease in HDL cholesterol, and increase in triglycerides, dyspepsia tends to occur less frequently. For instance, diarrhea is a common gastrointestinal reaction to fish oil supplements and can range from mild to severe. A decrease in HDL levels can also be observed with high doses of fish oil, which stands contrary to the usual protective effect HDL has against cardiovascular disease. The most notable concern is that in some cases, high doses of omega-3 fatty acids can lead to an increase in triglycerides, particularly when taken in inappropriate quantities or in different formulations. Thus, dyspepsia is the least commonly associated side effect with high-dose fish oil when assessed against these other potential side effects.