Journal of Clinical Endocrinology & Metabolism, Vol 62, 1081-1088, Copyright © 1986 by Endocrine Society

ARTICLES

Effect of differences in glucose tolerance on insulin's ability to regulate carbohydrate and free fatty acid metabolism in obese individuals

A Golay, YD Chen and GM Reaven

The effect of variations in glucose tolerance on insulin's ability to regulate glucose uptake and plasma glucose and FFA concentrations was assessed in 22 obese individuals [8 with normal glucose tolerance, 7 with impaired glucose tolerance (IGT), and 7 with noninsulin-dependent diabetes mellitus (NIDDM)]. Patients with IGT had ambient insulin levels that were higher than normal, associated with elevated postprandial glucose levels and a marked reduction in insulin- stimulated glucose uptake. On the other hand, plasma FFA levels were relatively normal in IGT, possibly because of the hyperinsulinemia. Patients with NIDDM were also hyperinsulinemic, with insulin levels throughout the day that were approximately twice normal. Hyperinsulinemia in patients with NIDDM was associated with a significant decline in insulin-stimulated glucose uptake as well as with significant increases in both ambient plasma glucose and FFA concentrations. Thus, and in contrast to patients with IGT, plasma FFA metabolism in NIDDM was grossly abnormal, despite the concomitant hyperinsulinemia. These data indicate that insulin resistance in obese individuals varies as a function of degree of glucose tolerance, and insulin resistance in patients with NIDDM involves defects in the regulation of both plasma glucose and FFA metabolism.

This article has been cited by other articles:

				S. P. Kim, K. J. Catalano, I. R. Hsu, J. D. Chiu, J. M. Richey, and R. N. Bergman Nocturnal free fatty acids are uniquely elevated in the longitudinal development of diet-induced insulin resistance and hyperinsulinemia Am J Physiol Endocrinol Metab, June 1, 2007; 292(6): E1590 - E1598. [Abstract] [Full Text] [PDF]

				F. Ashcroft and P. Rorsman Type 2 diabetes mellitus: not quite exciting enough? Hum. Mol. Genet., April 1, 2004; 13(suppl_1): R21 - R31. [Abstract] [Full Text] [PDF]

				E.-J. Freyse, T. Giessmann, K. J. Petzke, S. Knospe, G. Engel, P. Heinke, C. C. Metges, and W. Siegmund Effects of fatty acids on hepatic amino acid catabolism and fibrinogen synthesis in young healthy volunteers Am J Physiol Endocrinol Metab, July 1, 2003; 285(1): E54 - E62. [Abstract] [Full Text] [PDF]

				M. Ciampelli, F. Leoni, F. Lattanzi, M. Guido, R. Apa, and A. Lanzone A pilot study of the long-term effects of acipimox in polycystic ovarian syndrome Hum. Reprod., March 1, 2002; 17(3): 647 - 653. [Abstract] [Full Text] [PDF]

				M. Ciampelli, G. Muzj, F. Leoni, D. Romualdi, C. Belosi, R. M. Cento, and A. Lanzone Metabolic and Endocrine Consequences of Acute Suppression of FFAs by Acipimox in Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5324 - 5329. [Abstract] [Full Text] [PDF]

				M.-T. van der Merwe, P.-A. Jansson, N. J. Crowther, I. H. Boyd, I. P. Gray, B. I. Joffe, and P. N. Lönnroth Lactate and Glycerol Release from Subcutaneous Adipose Tissue in Black and White Lean Men J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2888 - 2895. [Abstract] [Full Text]

				C. Maffeis, F. Armellini, L. Tatò, and Y. Schutz Fat Oxidation and Adiposity in Prepubertal Children: Exogenous versus Endogenous Fat Utilization J. Clin. Endocrinol. Metab., February 1, 1999; 84(2): 654 - 658. [Abstract] [Full Text]

				V. Sanchez-Margalet and C. Gonzalez-Yanes Pancreastatin inhibits insulin action in rat adipocytes Am J Physiol Endocrinol Metab, December 1, 1998; 275(6): E1055 - E1060. [Abstract] [Full Text] [PDF]

				A. A. Dosso, F. Yenice-Ustun, J. Sommerhalder, A. Golay, Y. Morel, and P. M. Leuenberger Contrast Sensitivity in Obese Dyslipidemic Patients With Insulin Resistance Arch Ophthalmol, October 1, 1998; 116(10): 1316 - 1320. [Abstract] [Full Text] [PDF]

				A. Laws, H.M. Hoen, J.V. Selby, M.F. Saad, S.M. Haffner, and B.V. Howard Differences in Insulin Suppression of Free Fatty Acid Levels by Gender and Glucose Tolerance Status: Relation to Plasma Triglyceride and Apolipoprotein B Concentrations Arterioscler. Thromb. Vasc. Biol., January 1, 1997; 17(1): 64 - 71. [Abstract] [Full Text]