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 .
Insulin resistance, intramyocellular lipid content, and plasma adiponectin in patients with type 1 diabetes.
Insulin resistance is a key pathogenic factor of type 2 diabetes ( T2DM ) ; in contrast , in type 1 diabetes ( T1DM ) it is considered a secondary alteration . Increased intramyocellular lipid ( IMCL ) content accumulation and reduced plasma adiponectin were suggested to be pathogenic events of insulin resistance in T2DM . This study was design ed to assess whether IMCL content and plasma adiponectin were also associated with the severity of insulin resistance in T1DM . We studied 18 patients with T1DM , 7 older and overweight/obese patients with T2DM , and 15 nondiabetic , insulin-resistant offspring of T2DM parents ( OFF ) and 15 healthy individuals ( NOR ) as appropriate control groups matched for anthropometric features with T1DM patients by means of the euglycemic hyperinsulinemic clamp combined with the infusion of [6,6 - 2H2]glucose and 1H magnetic resonance spectroscopy of the calf muscles . T1DM and T2DM patients showed reduced insulin-stimulated glucose metabolic clearance rate ( MCR : 5.1 + /- 0.6 and 3.2 + /- 0.8 ml x kg(-1 ) min(-1 ) ) similar to OFF ( 5.3 + /- 0.4 ml x kg(-1 ) x min(-1 ) ) compared with NOR ( 8.5 + /- 0.5 ml x kg(-1 ) min(-1 ) , P < 0.001 ) . Soleus IMCL content was increased in T1DM ( 112 + /- 15 AU ) , T2DM ( 108 + /- 10 AU ) and OFF ( 82 + /- 13 AU ) compared with NOR ( 52 + /- 7 AU , P < 0.05 ) and the result was inversely proportional to the MCR ( R2 = 0.27 , P < 0.001 ) ; an association between IMCL content and Hb A1c was found only in T1DM ( R2 = 0.57 , P < 0.001 ) . Fasting plasma adiponectin was reduced in T2DM ( 7 + /- 1 microg/ml , P = 0.01 ) and OFF ( 11 + /- 1 microg/ml , P = 0.03 ) but not in T1DM ( 25 + /- 6 microg/ml ) , whose plasma level was increased with respect to both OFF ( P = 0.03 ) and NOR ( 16 + /- 2 microg/ml , P = 0.05 ) . In conclusion , in T1DM , T2DM , and OFF , IMCL content was associated with insulin resistance , demonstrating that IMCL accretion is a marker of insulin resistance common to both primary genetically determined and secondary metabolic ( chronic hyperglycemia ) alterations . The increased adiponectin levels in insulin-resistant patients with T1DM , in contrast to the reduced levels found in patients with T2DM and in OFF , demonstrated that the relationship of adiponectin to insulin resistance in humans is still unclear
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 .