Lack of thermogenic response to glucose/insulin infusion in diabetic obese subjects

A. Golay, J. P. Felber, Y. Schutz, R. A. de Fronzo, E. Jéquier

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

The change in energy expenditure consecutive to the infusion of glucose/insulin was examined in 17 non-obese (ten young, seven middle-aged) and 27 diabetic and non-diabetic obese subjects by employing the euglycemic insulin clamp technique in conjunction with continuous indirect calorimetry. The obese subjects were divided into four groups according to their response to a 100-g oral glucose test: Group A, normal glucose tolerance; group B, impaired glucose tolerance; group C, diabetes with increased insulin response; group D, diabetes with reduced insulin response. The glucose/insulin infusion provoked an increase in enery expenditure in both young and middle-aged controls (+8.2 ± 1.3 percent and +5.9 ± 0.5 percent over the preinfusion baseline respectively), but a lower increase in the non-diabetic obese groups A and B (+4.0 ± 0.7 percent and +2.0 ± 1.0 percent over the preinfusion baseline respectively, P < 0.05 and P < 0.01 vs young controls). However, in the diabetic obese groups C and D, energy expenditure failed to increase in response to the glucose/insulin infusion (mean change: +0.1 ± 1.0 percent and -2.0 ± 1.9 percent (P < 0.01, vs middle-aged) over the preinfusion baseline respectively). When the glucose-induced thermogenesis (GIT) was related to the glucose uptake - taking into account the hepatic glucose production - the GIT was found to be similarly reduced in the diabetics groups (C and D). The net change in the rate of energy expenditure was found to be significantly correlated with the rate of glucose uptake (r = +0.647, n = 44, P < 0.001) when all the individuals were pooled. In conclusion, this study shows that the low glucose-induced thermogenesis in obese diabetics during glucose insulin infusion is mainly related to a reduced rate of glucose uptake; in addition, inhibition of gluconeogenesis by the glucose/insulin infusion may also contribute to decrease the thermogenic response.

Original languageEnglish (US)
Pages (from-to)107-116
Number of pages10
JournalInternational Journal of Obesity
Volume10
Issue number2
StatePublished - Oct 22 1986
Externally publishedYes

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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