Issue 137 Item 13 Reduction of Fatty Acids Improves Insulin Secretion in Type 2

Acute reduction of circulating fatty acids with Acipimox improves insulin secretion in type 2 diabetic patients with low hemoglobin A1c levels. Investigators from Norwegian University of Science and Technology, in Trondheim, Norway, studied 21 patients with type 2 diabetes and hypertriglyceridamia alongside 10 age-matched non-diabetic controls.

Subjects underwent two hyperglycemic clamps for 120 minutes each with an infusion of Intralipid and heparin from minute 60 to 120. In one of the tests, subjects received 250 mg of Acipimox 60 minutes before the hyperglycemic clamp.

A third test including 17 of the diabetic patients was also conducted. In this test, patients followed a three-day low-fat diet before undergoing hyperglycemic clamps with Acipimox.

Results showed that Acipimox lowered fatty acid levels and increased insulin sensitivity in both diabetic and non-diabetic subjects.

Half of the diabetic patients — those with the lowest levels of hemoglobin A1c — showed increased insulin secretion during minutes 60 to 120 after taking Acipimox.

Neither the diabetic patients with higher hemoglobin A1c nor the non-diabetic controls showed any change in insulin secretion rates with Acipimox.

The low-fat diet reduced energy from fat from 39 to 23 percent, but had no effect on fatty acid levels or insulin response during the hyperglycemic clamp test.
Am J Physiol Endocrinol Metab 2003; 284(1): E129-137