The role of plasma fatty acid composition in endogenous glucose production in patients with type 2 diabetes mellitus

Metabolism ◽  
2002 ◽  
Vol 51 (11) ◽  
pp. 1471-1477 ◽  
Author(s):  
John N. Clore ◽  
James Allred ◽  
Danielle White ◽  
Jing Li ◽  
Julie Stillman
2011 ◽  
Vol 93 (1) ◽  
pp. e1-e2 ◽  
Author(s):  
Mitsuyoshi Takahara ◽  
Hideaki Kaneto ◽  
Naoto Katakami ◽  
Taka-aki Matsuoka ◽  
Munehide Matsuhisa ◽  
...  

2001 ◽  
Vol 33 (11) ◽  
pp. 659-663 ◽  
Author(s):  
A. M. Pereira Arias ◽  
P. H. Bisschop ◽  
M. T. Ackermans ◽  
E. Endert ◽  
J. A. Romijn ◽  
...  

2009 ◽  
Vol 297 (1) ◽  
pp. E165-E173 ◽  
Author(s):  
Sylvia Kehlenbrink ◽  
Julia Tonelli ◽  
Sudha Koppaka ◽  
Visvanathan Chandramouli ◽  
Meredith Hawkins ◽  
...  

Glucose effectiveness, the ability of glucose per se to suppress endogenous glucose production (EGP), is lost in type 2 diabetes mellitus (T2DM). Free fatty acids (FFA) may contribute to this loss of glucose effectiveness in T2DM by increasing gluconeogenesis (GNG) and impairing the response to hyperglycemia. Thus, we first examined the effects of increasing plasma FFA levels for 3, 6, or 16 h on glucose effectiveness in nondiabetic subjects. Under fixed hormonal conditions, hyperglycemia suppressed EGP by 61% in nondiabetic subjects. Raising FFA levels with Liposyn infusion for ≥3 h reduced the normal suppressive effect of glucose by one-half. Second, we hypothesized that inhibiting GNG would prevent the negative impact of FFA on glucose effectiveness. Raising plasma FFA levels increased gluconeogenesis by ∼52% during euglycemia and blunted the suppression of EGP by hyperglycemia. Infusion of ethanol rapidly inhibited GNG and doubled the suppression of EGP by hyperglycemia, thereby restoring glucose effectiveness. In conclusion, elevated FFA levels rapidly increased GNG and impaired hepatic glucose effectiveness in nondiabetic subjects. Inhibiting GNG could have therapeutic potential in restoring the regulation of glucose production in type 2 diabetes mellitus.


2004 ◽  
Vol 52 (6) ◽  
pp. 379-388 ◽  
Author(s):  
Jerry Radziuk ◽  
Susan Pye

Glycemia in type 2 diabetes is characterized by a nonsteady but stable diurnal cycle. This leads to morning fasting hyperglycemia. It arises from an underlying circadian pattern in endogenous glucose production because the metabolic clearance rate of glucose is decreased but constant. Therefore, it is important to use appropriate nonsteady tracer methods to measure this rate even under basal conditions. Postprandially, in diabetes, the endogenous glucose production continues to decrease, with only minor deviations from the slope of the basal curve. This suggests a decoupling of endogenous glucose production from the regulatory factors (insulin, glucose) that prevail under normal circumstances. As the duration of diabetes increases, metabolic clearance of glucose continues to deteriorate. This may be partially compensated by a decrease in glucose production. This rate remains, however, inappropriate because its impact on glycemia does not decline.


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