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Effects of acute starvation and of type 2 diabetes mellitus upon insulin resistance and substrate utilization in obese subjects
Duška, František ; Anděl, Michal (advisor) ; Haluzík, Martin (referee) ; Mourek, Jindřich (referee) ; Stárka, Luboslav (referee)
Very-low calorie diet or even total short-term fasting is widely used in clinical practice in order to improve metabolic compensation of patients with type 2 diabetes mellitus. Although benefits of weight reduction are well proven in T2DM, much less is known about effects of acute starvation, during which the interruption of the afflux of energy substrates is not followed by a major change of body composition. We hypothesize the improvement of insulin effects on glucose metabolism in T2DM as these patients may lack the key metabolic responses which impair insulin sensitivity in lean, non-diabetic subjects. Moreover, we assume according to "thrifty genotype hypothesis" that protein wasting during starvation will be positively related to insulin effects on glucose disposal and negatively related to insulin antilipolytic and antiketogenic effects. In the light of this we designed an observational, prospective, in-hospital study, comparing the effects of 60 hours fast on various aspects of insulin resistance, endocrine regulation and metabolism in 10 patients with T2DM and 10 obese controls without diabetes (OB).
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