ACUTE CHANGES IN PLASMA NONESTERIFIED FATTY-ACID CONCENTRATION DO NOT CHANGE HEPATIC GLUCOSE-PRODUCTION IN PEOPLE WITH TYPE-2 DIABETES

The effect of changes in plasma non‐esterified fatty acid concentration (NEFA) on plasma glucose concentration, hepatic glucose production (Ra), and glucose disposal (Rd) rates was determined in 14 patients with Type 2 diabetes. Seven patients had relatively mild fasting hyperglycaemia (< 10.0 mmol l−1), whereas the remaining seven had relatively severe fasting hyperglycaemia (> 14.0 mmol l−1). Each patient was infused from 2000 to 0800 h with 3‐3H‐glucose on two occasions, with or without neutral fat emulsion and heparin (mild hyperglycaemia group), or with or without nicotinic acid (severe hyperglycaemia group). Plasma NEFA concentration increased from 0.33 ± 0.06 (± SE) to 4.78 ± 0.42 mmol l−1 in response to the lipid and heparin infusion, but plasma glucose concentration (7.8 ± 0.7 vs 7.4 ± 0.8 mmol l−1), Ra (0.44 ± 0.02 vs 0.46 ± 0.02 mmol m−2 min−1), and Rd (0.42 ± 0.02 vs 0.46 ± 0.02 mmol m−2 min−1) were unchanged. Nicotinic acid decreased plasma NEFA concentration from 0.54 ± 0.15 to 0.23 ± 0.08 mmol l−1, but plasma glucose (15.0 ± 1.0 vs 15.5 ± 1.4 mmol l−1), Ra (0.74 ± 0.07 vs 0.68 ± 0.07 mmol m−2 min−1), and Rd (0.73 ± 0.07 vs 0.68 ± 0.07 mmol m−2 min−1) were unchanged. The results indicate that acute changes in plasma NEFA concentration did not lead to any change in overnight glucose production or disposal rates. 1990 Diabetes UK