[Metabolism of the ischemic myocardium in non-insulin-dependent diabetes]

Fourteen non-insulin-dependent diabetics enjoying good metabolic balance with diet alone and who had presented typical effort-induced angina symptomatology for at least two years have been examined. They were subjected to atrial pacing in accordance with routine protocols and blood samples were taken from the aortic bulb and from the coronary sinus for the measurement of glucose, triglycerides, NEFA, lactate, pyruvate and glycerol. The results obtained show an ischaemic type metabolism even under basal conditions, accentuated after effort. The reduction in triglycerides in the coronary sinus is only apparent and, through the mechanism of the increased production of NEFA, may account for the increase in mortality from acute myocardial infarction in the non-insulin-dependent diabetic.