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The Role of Plasma Non‐esterified Fatty Acids During Exercise in Type 2 Diabetes Mellitus
Author(s) -
Berrish T.S.,
Elliott C.,
Cooper B.G.,
Reed J.W.,
Orskov H.,
Alberti K.G.M.M.,
Walker M.
Publication year - 1993
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1993.tb00033.x
Subject(s) - medicine , type 2 diabetes mellitus , diabetes mellitus , endocrinology , type 2 diabetes
Elevated fasting plasma non‐esterified fatty acid (NEFA) levels have been reported in Type 2 diabetes. We examined whether such changes persist during low‐grade exercise and influence carbohydrate metabolism. Eight Type 2 diabetic patients with moderate glycaemic control and eight healthy controls received the anti‐lipolytic agent, acipimox, or placebo on separate occasions before exercising for 45 min at 35 % pre‐determined V o2 max. Fasting plasma NEFA levels were similar (0.40 ± 0.06 (SEM) and 0.45 ± 0.05 mmol l −1 ; healthy and Type 2 diabetic subjects) following placebo, and increased to comparable levels with exercise (0.73 ± 0.07 and 0.73 ± 0.10 mmol l −1 ). Acipimox lowered basal NEFA levels (0.14 ± 0.03 and 0.28 ± 0.04 mmol I −1 ; both p < 0.05 vs placebo), and prevented the rise with exercise. Blood glucose ( p < 0.001) and serum insulin ( p < 0.01) levels were higher in the Type 2 diabetic patients (vs controls) for both treatments. Whole body lipid oxidation increased from baseline to a comparable degree with exercise following placebo (3.2 ± 0.3 and 2.8 ± 0.3 mg kg −1 min −1 ; healthy and Type 2 diabetic subjects, both p < 0.02). Although less marked, the same was also observed following acipimox (2.0 ± 0.4 and 2.1 ± 0.5 mg kg −1 min −1 ; both p < 0.05). Carbohydrate oxidation increased with exercise in both subject groups, but with no significant difference between the treatments. Thus, the metabolic response to low‐grade exercise was normal in Type 2 diabetic patients with moderate glycaemic control, but occurred against a background of hyperinsulinaemia. Plasma NEFA do not exert a major regulatory effect on carbohydrate metabolism during low‐grade exercise.