Effects of free fatty acids on gluconeogenesis and autoregulation of glucose production in type 2 diabetes

G Boden, X Chen, E Capulong, M Mozzoli - Diabetes, 2001 - Am Diabetes Assoc
G Boden, X Chen, E Capulong, M Mozzoli
Diabetes, 2001Am Diabetes Assoc
Effects of endogenously derived free fatty acids (FFAs) on rates of gluconeogenesis
(GNG)(determined with 2H2O), glycogenolysis (GL), and endogenous glucose production
(EGP) were studied in 18 type 2 diabetic patients and in 7 nondiabetic control subjects
under three experimental conditions: 1) during an 8-h fast (from 16–24 h after the last meal),
when plasma FFA levels increased slowly; 2) during 4 h (from 16–20 h) of nicotinic acid (NA)
administration (fasting plus NA), when plasma FFAs decreased acutely; and 3) during 4 h …
Effects of endogenously derived free fatty acids (FFAs) on rates of gluconeogenesis (GNG) (determined with 2H2O), glycogenolysis (GL), and endogenous glucose production (EGP) were studied in 18 type 2 diabetic patients and in 7 nondiabetic control subjects under three experimental conditions: 1) during an 8-h fast (from 16–24 h after the last meal), when plasma FFA levels increased slowly; 2) during 4 h (from 16–20 h) of nicotinic acid (NA) administration (fasting plus NA), when plasma FFAs decreased acutely; and 3) during 4 h (from 20–24 h) after discontinuation of NA (FFA rebound), when plasma FFAs increased acutely. During fasting, FFAs increased from 636 to 711 μmol/l in type 2 diabetic patients and from 462 to 573 μmol/l in control subjects (P < 0.04), but GNG did not change in diabetic patients (6.9 vs. 6.5 μmol · kg–1 · min–1, P > 0.05) or in control subjects (5.1 vs. 5.4 μmol · kg–1 · min–1, P > 0.05). During fasting plus NA, FFAs decreased in diabetic patients and control subjects (from 593 to 193 and from 460 to 162 μmol/l, respectively); GNG decreased (from 6.1 to 4.2 and from 4.7 to 3.5 μmol · kg–1 · min−1), whereas GL decreased in diabetic patients (from 5.3 to 4.4 μmol · kg−1 · min−1) but increased in control subjects (from 5.4 to 7.2 μmol · kg−1 min−1). During the FFA rebound, FFAs increased in diabetic patients and control subjects (from 193 to 1,239 and from 162 to 1,491 μmol/l, respectively); GNG increased (from 4.2 to 5.4 and from 3.4 to 5.3 μmol · kg–1 · min–1 respectively), and GL decreased (from 4.4 to 3.4 and from 7.3 to 4.3 μmol · kg−1 · min−1, respectively). In summary, during an extended overnight fast, increasing plasma FFA levels stimulated GNG, whereas decreasing FFA levels inhibited GNG in both diabetic and control subjects; 20 h after the last meal, approximately one-third of GNG in both diabetic and control subjects was dependent on FFAs; and autoregulation of EGP by GL in response to decreasing GNG was impaired in diabetic patients.
Am Diabetes Assoc