The DOI matches its Crossref record; 72 of the 72 references it cites were found in a registry or an index.
Fuel selection in human skeletal muscle in insulin resistance: a reexamination.
Open accessAbstract
For many years, the Randle glucose fatty acid cycle has been invoked to explain insulin resistance in skeletal muscle of patients with type 2 diabetes or obesity. Increased fat oxidation was hypothesized to reduce glucose metabolism. The results of a number of investigations have shown that artificially increasing fat oxidation by provision of excess lipid does decrease glucose oxidation in the whole body. However, results obtained with rodent or human systems that more directly examined muscle fuel selection have found that skeletal muscle in insulin resistance is accompanied by increased, rather than decreased, muscle glucose oxidation under basal conditions and decreased glucose oxidation under insulin-stimulated circumstances, producing a state of "metabolic inflexibility." Such a situation could contribute to the accumulation of triglyceride within the myocyte, as has been observed in insulin resistance. Recent knowledge of insulin receptor signaling indicates that the accumulation of lipid products in muscle can interfere with insulin signaling and produce insulin resistance. Therefore, although the Randle cycle is a valid physiological principle, it may not explain insulin resistance in skeletal muscle.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Obesity is also characterized by metabolic alterations that involve mitochondrial defects causing reduced oxidation in skeletal muscle (12,13).”
From Expression of Mfn2, the Charcot-Marie-Tooth Neuropathy Type 2A Gene, in Human Skeletal Muscle (2005) · cites this paper as [13]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Skeletal muscle in human obesity is characterized by metabolic alterations, including insulin resistance, accumulation of intracellular triglycerides, reduced oxidation processes, and impaired glucose-induced thermogenesis (36”
From Mitofusin-2 Determines Mitochondrial Network Architecture and Mitochondrial Metabolism (2003) · cites this paper as [37]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The down-regulation of Mfn2 detected in skeletal muscle from obese subjects or obese rats together with the observation that Mfn2 promotes mitochondrial metabolism may explain some of the metabolic alterations observed during obesity and characterized by impaired muscle glucose oxidation and fatty acid oxidation (36-39”
From Mitofusin-2 Determines Mitochondrial Network Architecture and Mitochondrial Metabolism (2003) · cites this paper as [37]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Interestingly, insulin resistance associated with obesity and type 2 diabetes is characterized by reduced oxidative capacities in skeletal muscle (1,9,13).”
From Expression of Mfn2, the Charcot-Marie-Tooth Neuropathy Type 2A Gene, in Human Skeletal Muscle (2005) · cites this paper as [13]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“during high-intensity exercise, obese individuals and patients with T2DM can increase the RER to values comparable to those observed in lean individuals”
From Effect of Exercise Training on Fat Loss—Energetic Perspectives and the Role of Improved Adipose Tissue Function and Body Fat Distribution (2021) · cites this paper as Kelley and Mandarino, 2000
Experimental — accuracy not yet measured
In the citing paper
“A mismatch between availability and oxidation of lipids might induce ectopic fat deposition and lipotoxicity (17,24).”
From Metabolic flexibility to lipid availability during exercise is enhanced in individuals with high insulin sensitivity (2018) · cites this paper as [17]
In the citing paper
“In recent years it has become increasingly apparent that nutrient-induced substrate switching is often compromised in the settings of obesity and type 2 diabetes (Kelley and Mandarino, 2000).”
From Lipid-Induced Mitochondrial Stress and Insulin Action in Muscle (2012) · cites this paper as Kelley and Mandarino, 2000
In the citing paper
“There has been considerable published evidence for lower fasting lipid oxidation and lower ΔRQ in obesity and T2DM, at both the whole-body level and the tissue level (36–38).”
In the citing paper
“Skeletal muscle is highly reliant on fatty acid oxidation during fasting conditions but, more importantly, displays considerable plasticity in fuel oxidation, which is best exemplified by rapid switching between carbohydrate and lipid in response to insulin.”
In the citing paper
“Defects in skeletal muscle oxidative capacity and fat metabolism are highly correlated with insulin sensitivity (IS) (1,5,12) and are believed to contribute to the pathogenesis of insulin resistance (13,14).”
From Dynamic changes in fat oxidation in human primary myocytes mirror metabolic characteristics of the donor (2005) · cites this paper as [14]
In the citing paper
“Insulin-resistant obese patients however manifested a lesser reliance on fatty acid oxidation compared with lean individuals and did not show increased fatty acid oxidation after fasting or reduced fatty acid oxidation after insulin infusion.”
From Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease (2018) · cites this paper as [9]
In the citing paper
“The metabolic flexibility assessed by the ability to switch from fat to carbohydrate oxidation is usually impaired during a hyperinsulinemic clamp in insulin-resistant subjects; however, this “metabolic inflexibility” is mostly the consequence of impaired cellular glucose uptake.”
From Metabolic flexibility and insulin resistance (2008) · cites this paper as [26]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Romijn, J. A., Coyle, E. F., Sidossis, L. S., Gastaldelli, A., Horowitz, J. F., Endert, E., & Wolfe, R. R. (1993) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1993.265.3.e380 · Cited by 1,747
The Mitochondrial Carnitine Palmitoyltransferase System — From Concept to Molecular Analysis
McGarry, J. D., & Brown, N. F. (1997) · European Journal of Biochemistry · doi:10.1111/j.1432-1033.1997.00001.x · Cited by 1,616 · cited 1×
“The muscle isoform of CPT-I is quite sensitive to allosteric inhibition by malonyl CoA, the precursor of fatty acid synthesis (62).”
BackgroundMechanism of free fatty acid-induced insulin resistance in humans.
Roden, M., Price, T. B., Perseghin, G., Petersen, K. F., Rothman, D. L., Cline, G. W., & Shulman, G. I. (1996) · Journal of Clinical Investigation · doi:10.1172/jci118742 · Cited by 1,539
Dresner, A., Laurent, D., Marcucci, M., Griffin, M. E., Dufour, S., Cline, G. W., Slezak, L. A., Andersen, D. K., Hundal, R. S., Rothman, D. L., et al. (1999) · Journal of Clinical Investigation · doi:10.1172/jci5001 · Cited by 1,311
Skeletal Muscle Triglyceride Levels Are Inversely Related to Insulin Action
Pan, D. A., Lillioja, S., Kriketos, A. D., Milner, M. R., Baur, L. A., Bogardus, C., Jenkins, A. B., & Storlien, L. H. (1997) · Diabetes · doi:10.2337/diab.46.6.983 · Cited by 1,179
Skeletal muscle triglyceride levels are inversely related to insulin action
Pan, D. A., Lillioja, S., Kriketos, A. D., Milner, M. R., Baur, L. A., Bogardus, C., Jenkins, A. B., & Storlien, L. H. (1997) · Diabetes · doi:10.2337/diabetes.46.6.983 · Cited by 1,179
Kelley, D. E., Goodpaster, B., Wing, R. R., & Simoneau, J.-A. (1999) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1999.277.6.e1130 · Cited by 1,096
Self-citationEffect of fatty acids on glucose production and utilization in man.
Ferrannini, E., Barrett, E. J., Bevilacqua, S., & DeFronzo, R. A. (1983) · Journal of Clinical Investigation · doi:10.1172/jci111133 · Cited by 1,050
Goodpaster, B. H., Leland Thaete, F., Simoneau, J.-A., & Kelley, D. E. (1997) · Diabetes · doi:10.2337/diacare.46.10.1579 · Cited by 1,012
Self-citationStorlien, L. H., Jenkins, A. B., Chisholm, D. J., Pascoe, W. S., Khouri, S., & Kraegen, E. W. (1991) · Diabetes · doi:10.2337/diab.40.2.280 · Cited by 967
Research works printed but not linked: 2
- Randle PJ, Garland PB, Hales CN, Newsholme EA: The glucose fatty acid cycle: its role in insulin sensitivity and the metabolic disturbances of diabetes mel- DIABETES, VOL. 49, MAY 2000 litus. Lancet i:7285-7289, 1963
- Richter E, Ed. New York, Plenum Press, 1998, p. 263-270
Cited by
Sorted by citations
Items 101–134 of 134
DiMenna, F. J., & Arad, A. D. (2018) · BMC Sports Science, Medicine and Rehabilitation · doi:10.1186/s13102-018-0110-8 · Cited by 68
Gans, R. O. B. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.05.002 · Cited by 64
PPARs and the orchestration of metabolic fuel selection
Sugden, M. C., Zariwala, M. G., & Holness, M. J. (2009) · Pharmacological Research · doi:10.1016/j.phrs.2009.03.014 · Cited by 64
Intramyocellular lipid droplets and insulin sensitivity, the human perspective
Gemmink, A., Goodpaster, B. H., Schrauwen, P., & Hesselink, M. K. C. (2017) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2017.07.010 · Cited by 62
Brouwers, B., Schrauwen-Hinderling, V. B., Jelenik, T., Gemmink, A., Havekes, B., Bruls, Y., Dahlmans, D., Roden, M., Hesselink, M. K. C., & Schrauwen, P. (2017) · Clinical Science · doi:10.1042/cs20170261 · Cited by 59
Richter, E. A., Bilan, P. J., & Klip, A. (2025) · Physiological Reviews · doi:10.1152/physrev.00033.2024 · Cited by 64
Revisiting the diacylglycerol-induced insulin resistance hypothesis
Amati, F. (2012) · Obesity Reviews · doi:10.1111/j.1467-789x.2012.01036.x · Cited by 59
Kim, J. Y., Tfayli, H., Michaliszyn, S. F., & Arslanian, S. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-01958 · Cited by 55
Metabolic fluxes in skeletal muscle in relation to obesity and insulin resistance
Blaak, E. E. (2005) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2005.04.001 · Cited by 57
Færch, K., & Vaag, A. (2011) · Acta Diabetologica · doi:10.1007/s00592-010-0245-x · Cited by 52
Metabolic syndrome and its association with nonalcoholic steatohepatitis
Bril, F., Sanyal, A., & Cusi, K. (2023) · Clinics in Liver Disease · doi:10.1016/j.cld.2023.01.002 · Cited by 52
Jørgensen, W., Rud, K. A., Mortensen, O. H., Frandsen, L., Grunnet, N., & Quistorff, B. (2017) · Physiological Reports · doi:10.14814/phy2.13207 · Cited by 48
The contribution of race and diabetes status to metabolic flexibility in humans
Stull, A. J., Galgani, J. E., Johnson, W. D., & Cefalu, W. T. (2010) · Metabolism · doi:10.1016/j.metabol.2009.12.020 · Cited by 47
Metabolic flexibility and obesity in children and youth
Aucouturier, J., Duché, P., & Timmons, B. W. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2010.00812.x · Cited by 43
Role of lipid-derived mediators in skeletal muscle insulin resistance
Taube, A., Eckardt, K., & Eckel, J. (2009) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00241.2009 · Cited by 40
Farsi, P. F., Djazayery, A., Eshraghian, M. R., Koohdani, F., Saboor-Yaraghi, A. A., Derakhshanian, H., Zarei, M., Javanbakht, M. H., & Djalali, M. (2014) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/0004-2730000002861 · Cited by 40
Gaster, M., & Beck-Nielsen, H. (2004) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2004.05.006 · Cited by 38
Insulin resistance and metabolic flexibility as drivers of liver and cardiac disease in T2DM
Colosimo, S., Mitra, S. K., Chaudhury, T., & Marchesini, G. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.111016 · Cited by 38
Pearson, T., Wattis, J. A. D., King, J. R., MacDonald, I. A., & Mazzatti, D. J. (2016) · Bulletin of Mathematical Biology · doi:10.1007/s11538-016-0181-1 · Cited by 37
Fernández-Verdejo, R., Bajpeyi, S., Ravussin, E., & Galgani, J. E. (2018) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00126.2018 · Cited by 34
Nogiec, C., Burkart, A., Dreyfuss, J. M., Lerin, C., Kasif, S., & Patti, M.-E. (2015) · Molecular Metabolism · doi:10.1016/j.molmet.2014.12.012 · Cited by 34
Steinbacher, P., Feichtinger, R. G., Kedenko, L., Kedenko, I., Reinhardt, S., Schönauer, A.-L., Leitner, I., Sänger, A. M., Stoiber, W., Kofler, B., et al. (2015) · PLOS ONE · doi:10.1371/journal.pone.0123881 · Cited by 33
Skeletal muscle fuel selection occurs at the mitochondrial level
Kuzmiak-Glancy, S., & Willis, W. T. (2014) · Journal of Experimental Biology · doi:10.1242/jeb.098863 · Cited by 33
Metabolic flexibility is conserved in diabetic myotubes
Gaster, M. (2007) · Journal of Lipid Research · doi:10.1194/jlr.m600319-jlr200 · Cited by 29
Chronic liver diseases and erectile dysfunction
Zang, G., Sun, X., Sun, Y., Zhao, Y., Dong, Y., Pang, K., Cheng, P., Wang, M., & Zheng, Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1092353 · Cited by 21
Wallenius, K., Kjellstedt, A., Thalén, P., Löfgren, L., & Oakes, N. D. (2013) · PPAR Research · doi:10.1155/2013/305347 · Cited by 22
Targeting skeletal muscle mitochondrial health in obesity
Pileggi, C. A., Hooks, B. G., McPherson, R., Dent, R. R. M., & Harper, M.-E. (2022) · Clinical Science · doi:10.1042/cs20210506 · Cited by 21
Trinh, M. D., Plihalova, A., Gojda, J., Westlake, K., Spicka, J., Lattova, Z., Pretl, M., & Polak, J. (2021) · Scientific Reports · doi:10.1038/s41598-021-83018-1 · Cited by 20
Normal Metabolic Flexibility despite Insulin Resistance Women with Polycystic Ovary Syndrome
Adamska, A., Karczewska-Kupczewska, M., Nikolajuk, A., Otziomek, E., Górska, M., Kowalska, I., & Straczkowski, M. (2013) · Endocrine Journal · doi:10.1507/endocrj.ej13-0115 · Cited by 17
Targeting Intramyocellular Lipids to Improve Aging Muscle Function
Russ, D. W., Manickam, R., & Tipparaju, S. M. (2025) · Lipids in Health and Disease · doi:10.1186/s12944-025-02622-6 · Cited by 15
“First described in the context of a shift between aerobic and anaerobic metabolism in parasitic worms [76], the term was adopted to describe the capacity to adjust metabolic rate and substrate utilization to changing environmental demands and substrate availability [77, 78].”
Vigelsø, A., Gram, M., Wiuff, C., Hansen, C. N., Prats, C., Dela, F., & Helge, J. W. (2016) · European Journal of Applied Physiology · doi:10.1007/s00421-015-3302-x · Cited by 13
Miyata, Y., & Shimomura, I. (2013) · Journal of Diabetes Investigation · doi:10.1111/jdi.12064 · Cited by 13
Variance in respiratory quotient among daily activities and its association with obesity status
Júdice, P. B., Sardinha, L. B., & Silva, A. M. (2021) · International Journal of Obesity · doi:10.1038/s41366-020-0591-x · Cited by 6
Metabolomic biomarkers of polycystic ovary syndrome related-obesity: a review of the literature
Vonica, C. L., Farcas, A. D., Roman, G., Muresan, A. A., Fodor, A., Cernea, S., & Georgescu, C. E. (2020) · Revista Romana de Medicina de Laborator · doi:10.2478/rrlm-2020-0017 · Cited by 5
Metadata
- Authors
- Kelley, D. E., & Mandarino, L. J.
- Affiliations
- University of Pittsburgh (US)
- ORCID
- Mandarino, L J
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2000-05-01
- Volume
- 49
- Issue
- 5
- Pages
- 677-683
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2164122881
- Cited by
- 1,017
- References
- 72
- Citations by year
- 2026: 31 · 2025: 28 · 2024: 25 · 2023: 39 · 2022: 41 · 2021: 49 · 2020: 37 · 2019: 26 · 2018: 51 · 2017: 38 · 2016: 39 · 2015: 43 · 2014: 35 · 2013: 57 · 2012: 43
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
- Keywords
- insulin resistance, skeletal muscle, fuel selection, Randle cycle, glucose oxidation, fat oxidation, metabolic inflexibility, type 2 diabetes, obesity, insulin signaling, insulin receptor signaling, intramyocellular triglyceride, lipid accumulation
- MeSH terms
- Animals, Fatty Acids, Glucose, Humans, Insulin Resistance, Muscle, Skeletal, Lipid Metabolism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review