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 [3H-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 less than 0.01) and decreased significantly with insulin therapy (p less than 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 mumol/min; p less than 0.001) and decreased after insulin therapy (p less than 0.01). Hepatic glucose production correlated positively with basal metabolic rate both in Type 2 diabetic patients (r = 0.49; p less than 0.001) and in control subjects (r = 0.50; p less than 0.05). Lipid oxidation was increased in Type 2 diabetic patients compared with control subjects (1.68 +/- 0.05 vs 1.37 +/- 0.08 mumol.kg LBM-1.min-1; p less than 0.01) and decreased significantly after insulin therapy (p less than 0.05). The rate of lipid oxidation correlated positively with basal metabolic rate both in Type 2 diabetic patients (r = 0.36; p less than 0.01) and in control subjects (r = 0.51; p less than 0.01). These data demonstrate that basal metabolic rate, rates of hepatic glucose production and lipid oxidation are interrelated in Type 2 diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)