Silvio Buscemi1, Maria Donatelli2, Giuseppe Grosso3, Sonya Vasto4, Fabio Galvano3, Flavia Costa5, Giuseppe Rosafio2, Salvatore Verga2. 1. Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Laboratorio di Nutrizione Clinica, University of Palermo, Italy. Electronic address: silbus@tin.it. 2. Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Laboratorio di Nutrizione Clinica, University of Palermo, Italy. 3. Dipartimento di Scienze del Farmaco, University of Catania, Italy. 4. Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche (DIBIMEF), University of Palermo, Italy. 5. Servizio di Ingegneria Clinica, AOU Policlinico "P. Giaccone", Palermo, Italy.
Abstract
AIMS: Resting energy expenditure (REE) plays a critical role in the regulation of body weight, with important implications in type 2 diabetes (T2D). However, the relationships between REE and T2D have not been extensively evaluated. We compared REE in persons with diabetes and in persons without diabetes. We also investigated the acute effect of insulin on REE and venous lactate, the latter an indirect measure of neoglucogenetic activity. METHODS: REE was measured using indirect calorimetry in 14 newly diagnosed, untreated T2D adults and in 14 non-diabetic age-, gender- and body mass index-matched persons. The REE and lactate venous concentrations were also measured in a subgroup of 5 T2D patients in the hour following an IV insulin bolus. RESULTS: The REE normalized for fat-free mass (FFM) was significantly higher in T2D patients than in the group without diabetes (mean ± SD: 27.6 ± 1.9 vs. 25.8 ± 1.9 kcal/kg-FFM·24h; P=0.02). REE normalized for FFM was correlated with fasting plasma glucose concentration (r=0.51; P=0.005). Following the insulin venous bolus REE (0': 2,048 ± 242; 10': 1,804 ± 228; 20': 1,684 ± 230; 30': 1,634 ± 212; 45': 1,594 ± 179; 60': 1,625 ± 197 kcal/24h; P<0.001) and both glucose (P<0.001) and lactate (P<0.001) concentrations progressively declined in the ensuing hour. CONCLUSIONS: Patients with diabetes have a higher energy expenditure, likely a consequence of higher gluconeogenetic activity. This study may contribute to recognizing the nature of body weight reduction that occurs in concomitance with poorly controlled diabetes, and of body weight gain as commonly observed when hypoglycemic treatment is started.
AIMS: Resting energy expenditure (REE) plays a critical role in the regulation of body weight, with important implications in type 2 diabetes (T2D). However, the relationships between REE and T2D have not been extensively evaluated. We compared REE in persons with diabetes and in persons without diabetes. We also investigated the acute effect of insulin on REE and venous lactate, the latter an indirect measure of neoglucogenetic activity. METHODS: REE was measured using indirect calorimetry in 14 newly diagnosed, untreated T2D adults and in 14 non-diabetic age-, gender- and body mass index-matched persons. The REE and lactate venous concentrations were also measured in a subgroup of 5 T2D patients in the hour following an IV insulin bolus. RESULTS: The REE normalized for fat-free mass (FFM) was significantly higher in T2D patients than in the group without diabetes (mean ± SD: 27.6 ± 1.9 vs. 25.8 ± 1.9 kcal/kg-FFM·24h; P=0.02). REE normalized for FFM was correlated with fasting plasma glucose concentration (r=0.51; P=0.005). Following the insulin venous bolus REE (0': 2,048 ± 242; 10': 1,804 ± 228; 20': 1,684 ± 230; 30': 1,634 ± 212; 45': 1,594 ± 179; 60': 1,625 ± 197 kcal/24h; P<0.001) and both glucose (P<0.001) and lactate (P<0.001) concentrations progressively declined in the ensuing hour. CONCLUSIONS:Patients with diabetes have a higher energy expenditure, likely a consequence of higher gluconeogenetic activity. This study may contribute to recognizing the nature of body weight reduction that occurs in concomitance with poorly controlled diabetes, and of body weight gain as commonly observed when hypoglycemic treatment is started.
Authors: D Romualdi; V Versace; V Tagliaferri; S De Cicco; V Immediata; R Apa; M Guido; A Lanzone Journal: J Endocrinol Invest Date: 2019-03-07 Impact factor: 4.256
Authors: Christopher J Gaffney; Peter Mansell; Francis B Stephens; Ian A Macdonald; Kostas Tsintzas Journal: J Diabetes Res Date: 2017-05-29 Impact factor: 4.011