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Vol. 42, No. 6, 1998
Issue release date: November–December 1998
Ann Nutr Metab 1998;42:333–340

Respiratory Quotient in Patients with Non-Insulin-Dependent Diabetes mellitus Treated with Insulin and Oral Hypoglycemic Agents

Nakaya Y. · Ohnaka M. · Sakamoto S. · Niwa Y. · Okada K. · Nomura M. · Hara T. · Kusonoki M.
a Department of Nutrition, University of Tokushima, School of Medicine, and b First Department of Medicine, Aichi Medical School, Tokushima, Japan

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The respiratory quotient (RQ) reflects the amount of energy derived from carbohydrate as apposed to fat metabolism. To assess the metabolic state of patients with non-insulin-dependent diabetes mellitus, the RQ was measured five times a day (at 09.00, 11.00, 13.00, 14.00, and 17.00 h) in 20 healthy subjects and 60 diabetic patients. Diabetic patients treated with insulin or sulfonylurea showed significantly higher RQ values than normal subjects and nontreated diabetic patients. Diabetic patients without treatment showed higher glucose levels, and their RQ values were significantly lower than those of treated patients. There was a significant inverse correlation between RQ and blood glucose levels at 11.00 h (r = –0.361, p < 0.01) in diabetic patients, but no significant relation with HbA1c. Treated diabetic patients with a higher body mass index tended to show a higher RQ than those with a lower one (r = –0.269, p = 0.083). Within 1 year, 7 of 13 patients, who had RQ > 1.0, gained more than 3 kg, while only 5 of the remaining 32 treated diabetic patients gained more than 3 kg (p < 0.05). This demonstrates that diabetic patients with a higher RQ tended to gain weight despite the use of insulin or oral hypoglycemia agents. The RQ increased by infusing both insulin and glucose in normal subjects. These results suggest that a high RQ results from excess insulin and excess food. The RQ is a good predictor of weight gain in diabetic patients treated with either insulin or oral hypoglycemic agents.

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  1. The DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus: The Diabetes Control and Complications Trial. N Engl J Med 1993;329:977–986.
  2. The DCCT Research Group: Epidemiology of severe hypoglycemia in the Diabetes Control and Complications Trial. Am J Med 1990;90:450–459.
  3. The DCCT Research Group: Weight gain associated with intensive therapy in the Diabetes Control and Complications Trial. Diabetes Care 1988;11:567–573.
  4. Wing RR, Klein R, Moss SE: Weight gain associated with improved glycemic control in a population-based sample of subjects with type I diabetes. Diabetes Care 1990;13:1106–1109.
  5. American Diabetes Association: Standards of medical care for patients with diabetes mellitus. Position Statement. Diabetes Care 1995;18(suppl 1):8–12.
  6. Carlson MG, Campbell PJ: Intensive insulin therapy and weight gain in IDDM. Diabetes 1993;42:1700–1707.
  7. Jequier E, Acheson K, Schutz Y: Assessment of energy expenditure and fuel utilization in man. Annu Res Nutr 1987;7:187–208.
  8. Livesey G, Elia M: Estimation of energy expenditure, net carbohydrate utilization, and net fat oxidation and synthesis by indirect calorimetry: Evaluation of errors with special reference to the detailed composition of fuels. Am J Clin Nutr 1988;47:608–628.
  9. Ravussin E: Metabolic differences and the development of obesity. Metabolism 1995;44:12–14.
  10. Zurlo F, Lillioja S, Esposito-del Puente A: Low ratio of fat to carbohydrate oxidation as a predictor of weight gain: Study 24-RQ. Am J Physiol 1990;259:E650–E657.
  11. Zurlo F, Nemeth PM, Choksi RM, Sesodia S, Ravussin E: Whole-body energy metabolism and skeletal muscle biochemical characteristics. Metabolism 1994;43:481–486.
  12. Leslie P, Jung RT, Isles TE, Baly J, Newton RW, Illingworth P: Effect of optimal glycemic control with continuous subcutaneous insulin infusion on energy expenditure in type I diabetes mellitus. Br Med J 1988;293;1121–1126.
  13. Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982;54:254–260.
  14. Fassberg J, Toffler WL, Fields SA, Loriaux LD: Failure of insulin treatment in obese patients with non insulin dependent diabetes mellitus. J Fam Pract 1993;37:76–81.
  15. Kaplan NM: The deadly quartet: Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 1989;149:1514–1520.
  16. Soskin S, Levein R: A relationship between the blood sugar levels and the rate of sugar utilization, affecting the theories of diabetes. Am J Physiol 1937;120:761–770.
  17. Brown HF, Moorhouse JL: Glucose turnover and disposal in maturity onset diabetes. J Clin Invest 1973;52:303–319.
  18. Eckel RH: Insulin resistance: An adaptation for weight maintenance. Lancet 1992;340:1452–1453.

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