In patients with non-insulin-dependent diabetes mellitus (NIDDM) alterations in insulin secretion and insulin action coexist, and create and sustain hyperglycaemia, which results from an imbalance between glucose production and glucose utilization. The target organs for insulin action are the liver (restriction of glucose production), the muscle (acceleration of glucose disposal) and the adipose tissue (inhibition of free fatty acid mobilization). In NIDDM, the liver produces an inordinate amount of glucose, secondary to an acceleration of gluconeogenesis, and is insensitive to the inhibitory action of insulin on glucose production. In NIDDM, skeletal muscle takes up less glucose in response to hyperinsulinaemia. Adipose tissue mobilizes a larger amount of free fatty acid, thereby possibly enhancing glucose production in the liver (Randle’s cycle of metabolic competition between free fatty acids and glucose). Thus, the in vivo assessment of insulin action in NIDDM reveals a web of possibly interrelated metabolic defects, which in association with impaired insulin secretion cause a permanent, profound disruption of glucose homoeostasis.

Keywords:
Non-insulin-dependent diabetes mellitus, Glucose metabolism, Gluconeogenesis, Glycogen synthesis
This content is only available via PDF.
© 1993 S. Karger AG, Basel
1993
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.