FACTORS ASSOCIATED WITH BASAL METABOLIC-RATE IN PATIENTS WITH TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS

To examine determinants of basal metabolic rate we studied 66 Type 2 (non-insulin-dependent) diabetic and 24 healthy age- and weight-matched control subjects with indirect calorimetry and infusion of [H-3-3-] glucose. Eight Type 2 diabetic patients were re-studied after a period of insulin therapy. Basal metabolic rate was higher in Type 2 diabetic patients than in control subjects (102.8 +/- 1.9 J . kg LBM-1 . min-1 vs 90.7 +/- 2.8 J . kg LBM-1 . min-1; p < 0.01) and decreased significantly with insulin therapy (p < 0.01). The basal rate of hepatic glucose production was higher in Type 2 diabetic patients than in control subjects (1044.0 +/- 29.9 vs 789.3 +/- 41.7-mu-mol/min; p < 0.001) and decreased after insulin therapy (p < 0.01). Hepatic glucose production correlated positively with basal metabolic rate both in Type 2 diabetic patients (r = 0.49; p < 0.001) and in control subjects (r = 0.50; p < 0.05). Lipid oxidation was increased in Type 2 diabetic patients compared with control subjects (1.68 +/- 0.05 vs 1.37 +/- 0.08-mu-mol . kg LBM-1 . min-1; p < 0.01) and decreased significantly after insulin therapy (p < 0.05). The rate of lipid oxidation correlated positively with basal metabolic rate both in Type 2 diabetic patients (r = 0.36; p < 0.01) and in control subjects (r = 0.51; p < 0.01). These data demonstrate that basal metabolic rate, rates of hepatic glucose production and lipid oxidation are interrelated in Type 2 diabetic patients. A reduction of the hepatic glucose production, however, is associated with a reduction in lipid oxidation, which in turn, may result in a reduction in basal metabolic rate.