Three Months Energy Restricted Diet Does Not Reduce Peripheral Insulin Resistance in Newly Diagnosed Non Insulin Dependent Diabetics

Summary

Sixteen newly diagnosed non insulin dependent diabetic patients were treated for 3 months with an individual energy restricted diet. The effect on weight, hyperglycaemia and insulin response to oral glucose was measured in all subjects, and in 7, peripheral insulin resistance was estimated using a hyperinsulinaemic glucose clamp at two insulin infusion rates (40 and 400 mU m^-2 · min^-1). After diet, fasting plasma glucose fell from 12.0 ± 0.7 mmol/l (mean ± SEM) to 7.4 ± 0.5 mmol/l (P < 0.001) and weight fell from 92.9 ± 4.2 kg to 85.0 ± 3.1 kg (P < 0.001). The plasma insulin response to oral glucose was unchanged after diet therapy. Insulin induced glucose disposal (M) was also unaffected by diet at insulin infusion rates of 40 mU m^-2 · min^-1 (12.5 ± 1.5 μmol · kg^-1 · min^-1 vs 15.7 ± 1.6 μmol · kg^-1 · min^-1) and 400 mU m^-2 · min^-1 (49.5 ± 2.7 μmol · kg^-1 · min^-1 vs 55.1 ± 2.5 μmol · kg^-1 · min^-1). These results show that 3 months reduction of energy consumption with weight loss in newly diagnosed non insulin dependent diabetics improves B-cell responsiveness to glucose but has no effect on liver glucose output or on peripheral insulin action.

Key-Words

Energy Restricted Diet - Peripheral Insulin Resistance - Non Insulin Dependent Diabetes