Effect of cocoa in diabetes: The potential of the pancreas and liver as key target organs, more than an antioxidant effect?

Increasingly, type 2 diabetes mellitus is being linked to metabolic abnormalities within the liver and pancreas, associated with fat deposition and oxidative stress. Cocoa and chocolate have been seen to improve oxidative stress and enhance insulin sensitivity. Recent in vitro and animal model studies have begun to investigate the potential of cocoa and cocoa extracts in modulating fatty liver and pancreatic function. Evidence from these studies has highlighted a number of mechanisms, which facilitate insulin secretion and enhanced survival in pancreatic beta cells. Whilst in liver, improved effect of insulin was observed with some improvements in fatty infiltration. However, what was seen as a common effect was an increase in endogenous antioxidant capability. The potential of cocoa products in the management of fatty liver and supporting pancreatic function in humans is likely to be limited by their macronutrient and energy profile or palatability, unless taken as cocoa extract supplements.