Diabetologia

, Volume 41, Issue 10, pp 1127–1132

Lowering fatty acids potentiates acute insulin response in first degree relatives of people with Type II diabetes

  • G. Paolisso
  • M. R. Tagliamonte
  • M. R. Rizzo
  • P. Gualdiero
  • F. Saccomanno
  • A. Gambardella
  • D. Giugliano
  • F. D'Onofrio
  • B. V. Howard
Originals

DOI: 10.1007/s001250051041

Cite this article as:
Paolisso, G., Tagliamonte, M., Rizzo, M. et al. Diabetologia (1998) 41: 1127. doi:10.1007/s001250051041

Summary

Studies have shown that a high plasma non-esterified fatty acid concentration may inhibit glucose induced insulin secretion in vitro and in vivo. The effect of lowering the fatty acid concentration on the acute insulin response was investigated in first degree relatives of people with Type II diabetes in a double-blind, randomised, placebo-controlled trial. Fifty first degree relatives of people with Type II diabetes volunteered for the study. Twenty five were given acipimox (250 mg/day, four times daily) and 25 placebo. The group treated with acipimox had a lower 2-h plasma glucose concentration (6.1 ± 0.2 vs 7.7 ± 0.3 vs mmol/l, p < 0.01); better insulin-mediated glucose uptake (35.4 ± 0.5 vs 28.3 ± 0.4 μmol/kg fat free mass per min, p < 0.01), acute insulin response (68 ± 4.4 vs 46 ± 7.3 mU/l, p < 0.01) and respiratory quotient (0.81 ± 0.02 vs 0.77 ± 0.03, p < 0.05); and a rise in the plasma glucagon (164 ± 63 vs 134 ± 72 ng/l, p < 0.05), growth hormone (1.31 ± 0.13 vs 0.97 ± 0.21 μg/l, p < 0.03) and cortisol (325 ± 41 vs 284 ± 139 nmol/l, p < 0.05) concentrations. The difference in the acute insulin response persisted, even after adjustment for the 2-h plasma glucose concentration, insulin-mediated glucose uptake, the fasting plasma glucagon concentration and the growth hormone concentration (p < 0.05). In a subgroup of eight patients acipimox was compared with acipimox plus intralipid. The acute insulin response (44 ± 5.1 vs 71 ± 5.3 mU/l, p < 0.01) and the insulin-mediated glucose uptake (27.4 ± 0.4 vs 36.7 ± 0.5 μmol/kg fat free mass per min, p < 0.003) were lower with acipimox plus intralipid treatment than with acipimox alone. It is concluded that long term acipimox treatment lowers the plasma fasting free fatty acid concentration and improves the acute insulin response and the insulin mediated glucose uptake. [Diabetologia (1998) 41: 1127–1132]

Keywords Free fatty acids acipimox acute insulin response Type II diabetes mellitus insulin-mediated glucose uptake. 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • G. Paolisso
    • 1
  • M. R. Tagliamonte
    • 1
  • M. R. Rizzo
    • 1
  • P. Gualdiero
    • 1
  • F. Saccomanno
    • 1
  • A. Gambardella
    • 1
  • D. Giugliano
    • 1
  • F. D'Onofrio
    • 1
  • B. V. Howard
    • 2
  1. 1.Department of Geriatric Medicine and Metabolic Diseases, IInd University of Naples, Naples, ItalyIT
  2. 2.Medlantic Research Institute, Washington, USAUS