What question did this study set out to answer?

To determine whether altering plasma free fatty acid and insulin levels modulates myocardial glucose and fatty acid utilization, oxidation, and storage in humans with type 1 diabetes.

October 4, 2007DiabetesOpen Access

Fatty Acids and Insulin Modulate Myocardial Substrate Metabolism in Humans With Type 1 Diabetes

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Type 1 diabetes. Intervention: Altered plasma free fatty acid and insulin levels (hyperlipidemia, hyperinsulinemic-euglycemic clamp) vs. Nondiabetic subjects and euglycemia. Primary outcome: Myocardial oxygen consumption (MVo2), glucose, and fatty acid metabolism.

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Key result

Altering plasma free fatty acid and insulin levels in type 1 diabetes modulated myocardial glucose and fatty acid metabolism, despite baseline insulin resistance and higher myocardial oxygen consumption.

Why the study?

Does altering plasma free fatty acid and insulin levels modulate myocardial substrate metabolism in humans with type 1 diabetes?

Population

Humans with type 1 diabetes and nondiabetic control subjects

Comparison

Alteration of plasma free fatty acid and insulin… vs Nondiabetic control subjects and type 1 diabetic…

Design

Other

Authors

LPLinda R. PetersonWashington University in St. Louis PHPilar HerreroInstitut National des Sciences Appliquées de Lyon JMJanet B. McGillWashington University in St. Louis

Discussion

Member takes

Implication

Myocardial metabolic flexibility persists in type 1 diabetes despite insulin resistance; leaves open whether acute modulation improves outcomes.

Key Points

To determine whether altering plasma free fatty acid and insulin levels modulates myocardial glucose and fatty acid utilization, oxidation, and storage in humans with type 1 diabetes.
Quantified myocardial oxygen consumption, glucose utilization, and fatty acid kinetics using positron emission tomography.
Evaluated nondiabetic control subjects alongside type 1 diabetic subjects under euglycemia, hyperlipidemia, and hyperinsulinemic-euglycemic clamp conditions.
Type 1 diabetic subjects demonstrated higher myocardial oxygen consumption and lower myocardial glucose utilization rates per unit of insulin compared to nondiabetic controls.
In type 1 diabetes, myocardial glucose utilization increased with rising insulin and decreasing free fatty acids, while fatty acid utilization, oxidation, and esterification increased with higher free fatty acids.
Elevating plasma insulin reduced absolute myocardial fatty acid esterification rates while increasing the proportion of fatty acids routed toward esterification.

Study Design

Type

Observational

Structured PICO

Does altering plasma free fatty acid and insulin levels modulate myocardial substrate metabolism in humans with type 1 diabetes?

Population

Humans with type 1 diabetes and nondiabetic control subjects evaluated for myocardial metabolism using positron emission tomography.

Intervention

Alteration of plasma free fatty acid (FFA) and insulin levels (via hyperlipidemia and hyperinsulinemic-euglycemic clamp)

Comparator

Nondiabetic control subjects and type 1 diabetic subjects during euglycemia

Outcome

Myocardial oxygen consumption (MVo2), glucose, and fatty acid metabolism (utilization, oxidation, and esterification rates) quantified by positron emission tomographysurrogate

In humans with type 1 diabetes, the myocardium is insulin resistant but retains the ability to adapt its substrate metabolism in response to acute changes in plasma insulin and free fatty acid levels.

Cite This Study

Peterson et al. (2007) conducted an observational in Type 1 diabetes. Altered plasma free fatty acid and insulin levels (hyperlipidemia, hyperinsulinemic-euglycemic clamp) vs. Nondiabetic subjects and euglycemia was evaluated on Myocardial oxygen consumption (MVo2), glucose, and fatty acid metabolism. Altering plasma free fatty acid and insulin levels in type 1 diabetes modulated myocardial glucose and fatty acid metabolism, despite baseline insulin resistance and higher myocardial oxygen consumption.

synapsesocial.com/papers/6a75cd3dd17bc701ee16225d https://doi.org/10.2337/db07-1199

Topics

Echocardiography

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Implication

Myocardial metabolic flexibility persists in type 1 diabetes despite insulin resistance; leaves open whether acute modulation improves outcomes.

Fatty Acids and Insulin Modulate Myocardial Substrate Metabolism in Humans With Type 1 Diabetes

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Fatty Acids and Insulin Modulate Myocardial Substrate Metabolism in Humans With Type 1 Diabetes

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider