Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus

G. Perriello, P. Misericordia, Elena Volpi, S. Pampanelli, F. Santeusanio, P. Brunetti, G. B. Bolli

Research output: Contribution to journalArticle

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Abstract

Inasmuch as previous studies have obtained conflicting results on the contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus (NIDDM), we studied 10 nonobese and 10 obese NIDDM patients with the isoglycemic-(~10 mmol/L)-hyperinsulinemic clamp (two insulin infusions of 4 and 40 mU/m-2 min-1), combined with [3-3H] glucose infusion and indirect calorimetry. As compared with nonobese patients, obese NIDDM patients had higher baseline peripheral and estimated portal plasma insulin concentrations (113 ± 18 vs. 46 ± 3 pmol/L and 288 ± 53 vs. 98 ± 6 pmol/L, respectively; P < 0.05) and less suppressed endogenous insulin production during clamp. Hepatic glucose production was greater in obese than in nonobese patients (basal, 16 ± 1.1 vs. 12 ± 05 μmol/kg-1 fat-free mass (FFM) min-1; clamp, 5.7 ± 0.5 vs. 2.8 ± 0.2 μmol/kg-1 FFM min- 1, P < 0.05). Glucose utilization increased to a lesser extent in obese than in nonobese patients (49 ± 5 vs. 73 ± 7 μmol/kg-1 FFM min-1, P < 0.05) during clamp because of a lower increase in nonoxidative glucose metabolism (30 ± 5 vs. 50 ± 7 μmol/kg-1 FFM min-1, P < 0.05). Plasma free fatty acid concentrations and rates of lipid oxidation were greater in obese (P < 0.05) patients and correlated with hepatic glucose production (r = 0.79 and 0.50, P < 0.05). In conclusion, obesity exaggerates hepatic as well as extra- hepatic insulin resistance in NIDDM. The impaired inhibition of pancreatic β-cell function by exogenous insulin contributes to exaggerated hyperinsulinemia in obese NIDDM.

Original languageEnglish (US)
Pages (from-to)2464-2469
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume80
Issue number8
StatePublished - 1995
Externally publishedYes

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Medical problems
Type 2 Diabetes Mellitus
Insulin Resistance
Obesity
Clamping devices
Insulin
Glucose
Fats
Liver
Plasmas
Indirect Calorimetry
Hyperinsulinism
Calorimetry
Nonesterified Fatty Acids
Metabolism
Lipids
Oxidation

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Perriello, G., Misericordia, P., Volpi, E., Pampanelli, S., Santeusanio, F., Brunetti, P., & Bolli, G. B. (1995). Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus. Journal of Clinical Endocrinology and Metabolism, 80(8), 2464-2469.

Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus. / Perriello, G.; Misericordia, P.; Volpi, Elena; Pampanelli, S.; Santeusanio, F.; Brunetti, P.; Bolli, G. B.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 80, No. 8, 1995, p. 2464-2469.

Research output: Contribution to journalArticle

Perriello, G, Misericordia, P, Volpi, E, Pampanelli, S, Santeusanio, F, Brunetti, P & Bolli, GB 1995, 'Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus', Journal of Clinical Endocrinology and Metabolism, vol. 80, no. 8, pp. 2464-2469.
Perriello G, Misericordia P, Volpi E, Pampanelli S, Santeusanio F, Brunetti P et al. Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus. Journal of Clinical Endocrinology and Metabolism. 1995;80(8):2464-2469.
Perriello, G. ; Misericordia, P. ; Volpi, Elena ; Pampanelli, S. ; Santeusanio, F. ; Brunetti, P. ; Bolli, G. B. / Contribution of obesity to insulin resistance in noninsulin-dependent diabetes mellitus. In: Journal of Clinical Endocrinology and Metabolism. 1995 ; Vol. 80, No. 8. pp. 2464-2469.
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AU - Bolli, G. B.

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