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Metabolic (In)Flexibility of the Diabetic Heart

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Abstract

Introduction

Metabolic inflexibility was first described as a failure of skeletal muscle of diabetic subjects to appropriately move between use of lipid in the fasting state and use of carbohydrate in the insulin-stimulated prandial state. Metabolically healthy hearts have a well developed capacity to switch between lipid and carbohydrate fuels, depending on hormone levels and substrate availability in the circulation, but it is assumed that this flexibility is lost in the maladapted diabetic heart.

Objectives

We show in this short review that chronic treatment with lipid-lowering drugs, as well as acute administration of insulin and glucose, modulate the substrate flux in the diabetic heart. We also show that such interventions have functional implications in terms of improved cardiac efficiency and tolerance to ischemic stress.

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Acknowledgement

This work was supported by operating grants from the Norwegian Heart Foundation, the Norwegian Diabetes Association, the Novo Nordisk Foundation and the Northern Norway Regional Health Authority (HelseNord RHF). We are grateful to the PhD students Ole-Jakob How, Anne D. Hafstad and Ahmed Khalid for providing a large part of the ex vivo mouse heart data.

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Authors and Affiliations

  1. Department of Medical Physiology, Faculty of Medicine, Institute of Medical Biology, University of Tromsø, 9037, Tromsø, Norway

    Terje S. Larsen & Ellen Aasum

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  1. Terje S. Larsen
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  2. Ellen Aasum
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Correspondence to Terje S. Larsen.

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Larsen, T.S., Aasum, E. Metabolic (In)Flexibility of the Diabetic Heart. Cardiovasc Drugs Ther 22, 91–95 (2008). https://doi.org/10.1007/s10557-008-6083-1

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