A comparison of the lipaemic response to a mixed meal and the intravenous fat tolereance test in normolipidaemic and hyperlipidaemic non-insulin dependent diabetes mellitus (NIDDM)

The Intralipid tolerance test was compared with the post-prandial lipaemic response to a mixed meal in 14 subjects with Type II (non-insulin dependent) diabetes mellitus, of whom 7 had fasting hyperlipidaemia (serum cholesterol > 6. 5 mmol/l and/or serum triglyceride > 2.00 mmol/l). The fractional catabolic rate (-K₂) of Intralipid was inversely related to the maximum triglyceride response (MTR) (r - 0.65) and triglyceridaemic area under the curve (AUC) (r(s) - 0.68) following the meal, as well as fasting triglyceride levels (r(s) - 0.71). This was most apparent in hyperlipidaemic subjects MTR, AUC and fasting triglycerides were closely correlated with one another (r(s) 0.76-0.97). -K₂ was not correlated to HbA₁, total or HDL cholesterol. HbA₁ was not related to MTR or AUC, nor were fasting triglycerides in normolipidaemic subjects. Increased hepatic endogenous lipid secretion appears to accompany reduced clearance in Type II diabetes, particularly when hyperlipidaemia is present. Fasting triglyceride concentrations reglect post-prandial metabolism in hyperlipidaemic Type II diabetes.