title: Daily energy metabolism in patients with type 1 diabetes mellitus.
abstract: OBJECTIVE
  We evaluated the daily energy balance and main substrate utilization in Type 1 insulin dependent diabetic patients and healthy volunteers.
  
  
  METHODS
  Ten patients with Type 1 diabetes mellitus and eight healthy volunteers were studied. Diabetic patients were well controlled under intensive insulin treatment (0.6 UI/kg body weight, HbA1c = 5.5 +/- 0.7%). During the 30 hours each subject spent in the respiration chamber VO2, VCO2, respiratory quotient, daily energy intake, 24-hour, day-time, night-time and basal energy expenditure as well as energy expenditure during exercise (at 40% maximal exercise capacity), main substrate oxidation (carbohydrates, lipids and proteins) and overall diet-induced thermogenesis, were measured. The results were corrected for 24-hour urinary nitrogen loss.
  
  
  RESULTS
  Diet-induced thermogenesis, expressed as percent of energy intake, was found to be significantly lower in diabetic patients than in control subjects (6.69 +/- 1.29% vs 11.8 +/- 4.71% of energy intake, p < 0.05). A negative correlation was found between diet-induced thermogenesis and daily average glycemia for diabetic patients (r = -0.65, p < 0.01). Energy expenditure during exercise, calculated in terms of net work efficiency, was not different between the two groups.
  
  
  CONCLUSIONS
  In conclusion, since diet-induced thermogenesis is highly correlated with the theoretical cost of glucose storage and since no difference was found in carbohydrate oxidation, glucose storage in diabetic patients is probably reduced when hyperglycemia occurs. Diabetic patients in good metabolic control are able to perform mild exercise with a work efficiency very similar to that of control subjects.
authors.affiliation: Department of Internal Medicine, Catholic University, Rome, Italy.
authors.forename: A V
authors.initials: AV
authors.lastname: Greco
authors.forename: P A
authors.initials: PA
authors.lastname: Tataranni
authors.forename: G
authors.initials: G
authors.lastname: Mingrone
authors.forename: A
authors.initials: A
authors.lastname: De Gaetano
authors.forename: A
authors.initials: A
authors.lastname: Manto
authors.forename: P
authors.initials: P
authors.lastname: Cotroneo
authors.forename: G
authors.initials: G
authors.lastname: Ghirlanda
mesh_terms: D000328:Adult; D000886:Anthropometry; D001833:Body Temperature Regulation / Q000502:physiology; D050260:Carbohydrate Metabolism; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000378:metabolism*; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D050356:Lipid Metabolism; D008297:Male; D010084:Oxidation-Reduction; D010101:Oxygen Consumption / Q000502:physiology
chemical_list: D007328:Insulin