Insulin mediated inhibition of lipolysis was decreased in patients , reflected by increased non-esterified fatty acid levels .
Insulin resistance is a prominent feature of patients with type 1 diabetes mellitus and involves hepatic , peripheral and adipose tissues
OBJECTIVE The aim of this study was to perform a systematic review and meta- analysis on insulin resistance in adult patients with type 1 diabetes mellitus compared to healthy controls , assessed by hyperinsulinemic euglycemic clamp studies .
Impaired insulin stimulation of muscular ATP production in patients with type 1 diabetes.
OBJECTIVE in type 2 diabetic patients and their first-degree relatives , insulin resistance ( IR ) is associated with impairment of insulin-stimulated myocellular glucose-6-phosphate ( g6p ) and unidirectional flux through ATP synthase ( fATP ) , suggesting the presence of inherited abnormal mitochondrial oxidative fitness . We hypothesized that patients with long-st and ing type 1 diabetes may also exhibit insulin resistance as well as lower fATP . DESIGN this single-centre trial was registered at Clinical Trials.gov ( NCT00481598 ) . SUBJECTS we included eight nonobese type 1 diabetic patients ( mean diabetes duration : 17 years ) with near-target glycaemic control [ haemoglobin A1c ( HbA1c ) : 6.8 ± 0.4 % ] during treatment with continuous subcutaneous insulin infusion pumps and eight healthy volunteers ( HbA1c : 5.4 ± 0.2 % ) of comparable age , body mass and level of physical activity . OUTCOME MEASURES myocellular fATP , g6p and intramyocellular lipid content ( IMCL ) were measured with ( 1 ) H/(31 ) P magnetic resonance spectroscopy during fasting and hyperinsulinaemic-euglycaemic clamp tests . RESULTS fasting fATP , g6p and IMCL did not differ between groups . During stimulation by insulin , type 1 diabetic patients exhibited approximately 50 % ( P < 0.001 ) lower whole-body glucose disposal along with approximately 42 % ( P = 0.003 ) lower intramyocellular g6p and approximately25 % ( P = 0.024 ) lower fATP . Insulin-stimulated fATP correlated positively with whole-body insulin sensitivity ( R = 0.706 , P = 0.002 ) and negatively with HbA1c ( R = -0.675 , P = 0.004 ) . CONCLUSIONS despite documented near-target glycaemic control for 1 year , nonobese patients with long-st and ing type 1 diabetes can exhibit insulin resistance . This associates with lower insulin-stimulated flux through muscular ATP synthase which could result from glucose toxicity
Insulin mediated inhibition of lipolysis was decreased in patients , reflected by increased non-esterified fatty acid levels .
Insulin resistance is a prominent feature of patients with type 1 diabetes mellitus and involves hepatic , peripheral and adipose tissues
OBJECTIVE The aim of this study was to perform a systematic review and meta- analysis on insulin resistance in adult patients with type 1 diabetes mellitus compared to healthy controls , assessed by hyperinsulinemic euglycemic clamp studies .