title: Impact of endogenous and exogenous insulin on basal energy expenditure in patients with type 2 diabetes under standard treatment.
abstract: BACKGROUND
  Factors that affect resting energy expenditure or basal energy expenditure (BEE) in patients with type 2 diabetes under standard treatment have not been evaluated in detail.
  
  
  OBJECTIVE
  We determined the clinical factors that affected BEE in addition to body composition in patients with type 2 diabetes under standard treatment.
  
  
  METHODS
  BEE was measured by using indirect calorimetry under a strict basal condition in 58 Japanese patients with type 2 diabetes after >7 d as inpatients under management of diabetes with medical nutrition therapy and medications. Insulin secretion was measured with a glucagon test. Stepwise regression was applied to explore determinants of BEE.
  
  
  RESULTS
  In the stepwise estimation, insulin secretion (P = 0.015), insulin therapy (P = 0.012), and pulse rate (P = 0.011) were selected in addition to fat-free mass (FFM) (P < 0.001) and fat mass (P = 0.006) as significant independent determinants of BEE. Standardized partial regression coefficients of the additional 3 factors were -0.16, -0.15, and 0.15, respectively, whereas those for FFM and fat mass were 0.82 and 0.19, respectively. The additional 3 factors explained another 3.9% of the variability of BEE, and the adjusted coefficient of determination was 83.4%. Age, sex, other medications, and parameters of glycemic control were not significant determinants beyond the combined contribution of body composition, endogenous and exogenous insulin, and pulse rate.
  
  
  CONCLUSIONS
  Endogenous insulin secretion and exogenous insulin administered in treatment have significant independent effects in the lowering of BEE in patients with diabetes under standard management with medical nutrition therapy and medications.
authors: Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Japan.
authors: Kaori
authors: K
authors: Ikeda
authors: Shimpei
authors: S
authors: Fujimoto
authors: Masashi
authors: M
authors: Goto
authors: Chizumi
authors: C
authors: Yamada
authors: Akihiro
authors: A
authors: Hamasaki
authors: Kenichiro
authors: K
authors: Shide
authors: Takashi
authors: T
authors: Kawamura
authors: Nobuya
authors: N
authors: Inagaki
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D001481:Basal Metabolism / Q000187:drug effects / Q000502:physiology*; D001823:Body Composition / Q000502:physiology*; D001825:Body Fluid Compartments / Q000378:metabolism*; D002153:Calorimetry, Indirect; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000378:metabolism* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged
chemical_list: D007328:Insulin