Hepatic insulin resistance in obese non-diabetic subjects and in type 2 diabetic patients
Open accessAbstract
OBJECTIVE: Obese non-diabetic patients are characterized by an extra-hepatic insulin resistance. Whether obese patients also have decreased hepatic insulin sensitivity remains controversial. RESEARCH METHODS AND PROCEDURES: To estimate their hepatic insulin sensitivity, we measured the rate of exogenous insulin infusion required to maintain mildly elevated glycemia in obese patients with type 2 diabetes, obese non-diabetic patients, and lean control subjects during constant infusions of somatostatin and physiological low-glucagon replacement infusions. To account for differences in insulin concentrations among the three groups of subjects, an additional protocol was also performed in healthy lean subjects with higher insulin infusion rates and exogenous dextrose infusion. RESULTS: The insulin infusion rate required to maintain glycemia at 8.5 mM was increased 4-fold in obese patients with type 2 diabetes and 1.5-fold in obese non-diabetic patients. The net endogenous glucose production (measured with 6,6-(2)H(2)-glucose) and total glucose output (measured with 2-(2)H(1)-glucose) were approximately 30% lower in the patients than in the lean subjects. Net endogenous glucose production and total glucose output were both markedly increased in both groups of obese patients compared with lean control subjects during hyperinsulinemia. DISCUSSION: Our data indicate that both obese non-diabetic and obese type 2 diabetic patients have a blunted suppressive action of insulin on glucose production, indicating hepatic and renal insulin resistance.
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When age-, gender-, and weight-matched groups have been compared, hepatic insulin resistance has frequently been reported to be comparable.
“but when age-, gender-, and weight-matched groups have been compared, hepatic insulin resistance has frequently been reported to be comparable.[27][28][29][30][31][32]”
From Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. (2008) · cites this paper as [29]
S-free insulin concentrations during exogenously induced hyperinsulinemia have been found to be significantly higher in type 2 diabetic patients than in normal subjects in some studies.
“S-free insulin concentrations during exogenously induced hyperinsulinemia have been found to be significantly higher in type 2 diabetic patients than in normal subjects in some of these studies.27,29”
From Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. (2008) · cites this paper as [29]
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- Authors
- Paquot, N., Scheen, A. J., Dirlewanger, M., Lefèbvre, P. J., & Tappy, L.
- Affiliations
- University of Liège (BE)
- University of Lausanne (CH)
- Corresponding author
- Tappy, Luc
- Venue
- Obesity Research
- Publisher
- Wiley
- Published
- 2002-03
- Volume
- 10
- Issue
- 3
- Pages
- 129-134
- ISSN
- 1071-7323 (ISSN-L)
- 1550-8528
- OpenAlex
- W2006726523
- Cited by
- 37
- References
- 19
- Citations by year
- 2025: 1 · 2021: 1 · 2019: 2 · 2018: 1 · 2015: 3 · 2013: 1 · 2012: 1
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Research (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- ORBi (University of Liège) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (56700)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- hepatic insulin resistance, type 2 diabetes, obesity, insulin sensitivity, endogenous glucose production, glucose production, hyperinsulinemic-euglycemic clamp, somatostatin, glucagon
- MeSH terms
- Adult, Aged, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 2, Fatty Acids, Nonesterified, Female, Glucagon, Humans, Insulin, Insulin Resistance, Liver, Male, Middle Aged, Obesity, Somatostatin
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