Endocrine Abstracts

The pathophysiology of type 2 DM is complex and involves insulin resistance, pancreatic beta cell dysfunction and visceral adiposity. The levels of free fatty acids (FFA) increases in obese persons and diabetic patients. Elevated levels of FFAs may cause resistance and deficient insulin secretion. Our aim in this study was to investigate the change of FFA levels, glucose, insulin and triglyceride in fasting and postprandial state in 15 healthy controls and 45 diabetic patients under treatment of various agents.

Our study included four groups; 15 patients on diet or plus metformine, 15 patients using rapid acting insulin analogues, 15 patients having glinides, 15 healthy controls. Blood samples were withdrawn at fasting and following breakfast composed of foods proper for each person, at 60th, 90th and 120th min.

In control group glycemia peak occured at 90th min and insulin peaked at 60th min, when the levels of FFA was lowest. In the group of patients using glinide, glycemia and insulin levels peaked at 90th min. In the group of patients on diet and metformin, glycemia and insulin levels peaked at 60th min, whereas glycemia has peaked at 60th and 90th min at insulin group. FFA levels were lowest at 120th min in both groups. In the group of patients using insulin analogues glycemia levels peaked at 60th min, FFA levels were lowest at 120th min. FFAs were decreasing postprandially in all groups.

Basal FFA and TG levels were higher in diabetic patients than controls but the difference was not statistically significant. At postprandial phase: 1-FFAs suppression was late in diabetic patients independent from the treatment modality comparing with the healthy individuals. 2-FFA level was inversly associated with insulin and positively associated with HbA1c and fructosamine.

Conclusion: A reduction in elevated plasma FFA should be an important therapeutic target in type 2 diabetes.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.