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document
Nicotine infusion acutely impairs insulin sensitivity in type 2 diabetic patients but not in healthy subjects . OBJECTIVES The aim of this study was to examine if an acute nicotine infusion alters insulin sensitivity to a similar degree in type 2 diabetic patients as in healthy control subjects . DESIGN . Double-blind , cross-over , placebo-controlled , randomized experimental study . Nicotine 0.3 microg kg-1 min ( -1 ) or NaCl was infused ( 2 h ) during a euglycaemic hyperinsulinaemic clamp ( 4 h ) to assess insulin sensitivity . SETTING University research laboratory . SUBJECTS Six male and female type 2 diabetic patients [ DM2 ; age 54 +/- 10 ( mean +/- SD ) years ; body mass index ( BMI ) 25.6 +/- 2.9 kg m ( -2 ) ] treated with diet or one oral hypoglycaemic agent and six age- and BMI-matched control subjects ( Ctr ) . MAIN OUTCOME MEASURE Insulin sensitivity ( rate of glucose infusion per kg fat free body mass and minute ) , nicotine and free fatty acid ( FFA ) levels , pulse rate and blood pressure . RESULTS The infusions produced similar nicotine levels in both groups . In the absence of nicotine , DM2 were more insulin resistant than Ctr ( 6.7 +/- 0.4 vs. 10.9 +/- 0.3 mg kg-1 LBM min ( -1 ) , respectively ; P < 0.0001 ) . This insulin resistance was further aggravated by the nicotine infusion in DM2 but not in Ctr ( 4.6 +/- 0.3 vs. 10.9 +/- 0.3 mg kg ( -1 ) LBM min ( -1 ) ; P < 0.0001 ) . Only minor differences were seen in FFA levels , pulse rates and blood pressure . CONCLUSIONS At this low infusion rate , nicotine aggravated the insulin resistance in DM2 but not in Ctr . This finding may be because of the ( dysmetabolic ) diabetic state per se or to an increased sensitivity to environmental factors associated with a genetic predisposition for type 2 diabetes . These results show that diabetic subjects are particularly susceptible to the detrimental effects of nicotine .
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Intervention_Pharmacological
Nicotine
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Intervention_Pharmacological
nicotine
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
Nicotine
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Intervention_Control
or NaCl was infused
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Intervention_Pharmacological
nicotine
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Intervention_Pharmacological
nicotine
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Intervention_Pharmacological
nicotine
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Outcome_Other
Insulin sensitivity ( rate of glucose infusion per kg fat free body mass and minute ) ,
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Outcome_Physical
nicotine and free fatty acid ( FFA ) levels
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Outcome_Physical
pulse rate
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Outcome_Physical
blood pressure
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Outcome_Physical
insulin resistant
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Outcome_Physical
insulin resistance
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Outcome_Physical
FFA levels
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Outcome_Physical
pulse rates
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Outcome_Physical
blood pressure
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Outcome_Physical
insulin resistance
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Participant_Condition
type 2 diabetic patients