Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Fat oxidation, body composition and insulin sensitivity in diabetic and normoglycaemic obese adults 5 years after weight loss


OBJECTIVE: To investigate whether normal glucose-tolerant and type II diabetic overweight adults differ in response to weight regain with regard to substrate oxidation and metabolic parameters.

METHODS: A total of 15 overweight-obese subjects: seven normal glucose tolerant (NGT) and eight with type II diabetes (DM) were restudied 5 y after significant weight loss. Prediet, after 28 days calorie restriction and at 5 y, subjects were characterised for weight, height, waist-to-hip ratio (WHR) and body composition by dual-energy X-ray absorptiometry. Fasting glucose, insulin, leptin and lipid levels were measured and subjects underwent euglycaemic–hyperinsulinaemic clamp (insulin 0.25 U/kg/h for 150 min). Indirect calorimetry was performed resting and in the final 30 min of the clamp. Dietary assessment was by 4-day diet-diary.

RESULTS: Both NGT and DM groups regained weight at 5 y and were not different to prediet. Total body fat (%) and WHR were higher at 5 y compared to prediet in both groups. Fasting glucose was increased in NGT subjects at 5 y, and fasting insulin was higher in both groups at 5 y compared to prediet. Insulin sensitivity (GIR) was similar at 5 y compared to prediet, but at 5 y DM subjects were more insulin resistant than NGT subjects. At 5 y, both DM and NGT groups had significantly reduced basal fat oxidation and no significant suppression of fat oxidation with insulin. Clamp respiratory quotient levels at 5 y were significantly higher in NGT compared to DM subjects.

CONCLUSION: Reduced basal fat oxidation, and reduced variation in substrate oxidation in response to insulin develop with fat regain and fasting hyperinsulinaemia in both NGT and DM obese adults.

Your institute does not have access to this article

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1
Figure 2


  1. Kelley DE, Goodpaster B, Wing RR, Simoneau JA . Skeletal muscle fatty acid metabolism in association with insulin resistance, obesity, and weight loss. Am J Physiol 1999; 277: E1130–E1141.

    CAS  Article  PubMed  Google Scholar 

  2. Zurlo F, Lillioja S, Esposito-Del Puente A, Nyomba BL, Raz I, Saad MF, Swinburn BA, Knowler WC, Bogardus C, Ravussin E . Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ. Am J Physiol 1990; 259: E650–E657.

    CAS  PubMed  Google Scholar 

  3. Pan DA, Lillioja S, Kriketos AD, Milner MR, Baur LA, Bogardus C, Jenkins AB, Storlien LH . Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes 1997; 46: 983–988.

    CAS  Article  PubMed  Google Scholar 

  4. Ellis BA, Poynten A, Lowy AJ, Furler SM, Chisholm DJ, Kraegen EW, Cooney GJ . Long-chain acyl-CoA esters as indicators of lipid metabolism and insulin sensitivity in rat and human muscle. Am J Physiol Endocrinol Metab 2000; 279: E554–E560.

    CAS  Article  PubMed  Google Scholar 

  5. Astrup A, Buemann B, Christensen NJ, Toubro S . Failure to increase lipid oxidation in response to increasing dietary fat content in formerly obese women. Am J Physiol 1994; 266: E592–E599.

    CAS  PubMed  Google Scholar 

  6. Felber JP, Ferrannini E, Golay A, Meyer HU, Theibaud D, Curchod B, Maeder E, Jequier E, DeFronzo RA . Role of lipid oxidation in pathogenesis of insulin resistance of obesity and type II diabetes. Diabetes 1987; 36: 1341–1350.

    CAS  Article  PubMed  Google Scholar 

  7. Markovic TP, Campbell LV, Balasubramanian S, Jenkins AB, Fleury AC, Simons LA, Chisholm DJ . Beneficial effect on average lipid levels from energy restriction and fat loss in obese individuals with or without type 2 diabetes. Diabetes Care 1998; 21: 695–700.

    CAS  Article  PubMed  Google Scholar 

  8. Markovic TP, Jenkins AB, Campbell LV, Furler SM, Kraegen EW, Chisholm DJ . The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM. Diabetes Care 1998; 21: 687–694.

    CAS  Article  PubMed  Google Scholar 

  9. Furler SM, Poynten AM, Kriketos AD, Lowy AJ, Ellis BA, Maclean EL, Courtenay BG, Kraegen EW, Campbell LV, Chisholm DJ . Independent influences of central fat and skeletal muscle lipids on insulin sensitivity. Obes Res 2001; 9: 535–543.

    CAS  Article  PubMed  Google Scholar 

  10. Jensen MD, Kanaley JA, Reed JE, Sheedy PF . Measurement of abdominal and visceral fat with computed tomography and dual-energy x-ray absorptiometry. Am J Clin Nutr 1995; 61: 274–278.

    CAS  Article  PubMed  Google Scholar 

  11. Paradisi G, Smith L, Burtner C, Leaming R, Garvey WT, Hook G, Johnson A, Cronin J, Steinberg HO, Baron AD . Dual energy X-ray absorptiometry assessment of fat mass distribution and its association with the insulin resistance syndrome. Diabetes Care 1999; 22: 1310–1317.

    CAS  Article  PubMed  Google Scholar 

  12. DeFronzo RA, Tobin JD, Andres R . Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979; 237: E214–E223.

    CAS  PubMed  Google Scholar 

  13. Ferrannini E . The theoretical bases of indirect calorimetry: a review. Metabolism 1988; 37: 287–301.

    CAS  Article  PubMed  Google Scholar 

  14. Frayn KN . Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol 1983; 55: 628–634.

    CAS  Article  PubMed  Google Scholar 

  15. Kannel WB, Sorlie P . Some health benefits of physical activity. The Framingham Study. Arch Intern Med 1979; 139: 857–861.

    CAS  Article  PubMed  Google Scholar 

  16. Markovic TP, Furler SM, Jenkins AB, Campbell LV, Kraegen EW, Chisholm DJ . Importance of early insulin levels on prandial glycaemic responses and thermogenesis in non-insulin-dependent diabetes mellitus. Diabet Med 1995; 12: 523–530.

    CAS  Article  PubMed  Google Scholar 

  17. Sarlio-Lahteenkorva S, Rissanen A, Kaprio J . A descriptive study of weight loss maintenance: 6 and 15 year follow-up of initially overweight adults. Int J Obes Relat Metab Disord 2000; 24: 116–125.

    CAS  Article  PubMed  Google Scholar 

  18. Manning RM, Jung RT, Leese GP, Newton RW . The comparison of four weight reduction strategies aimed at overweight patients with diabetes mellitus: four-year follow-up. Diabet Med 1998; 15: 497–502.

    CAS  Article  PubMed  Google Scholar 

  19. Siervogel RM, Wisemandle W, Maynard LM, Guo SS, Chumlea WC, Towne B . Lifetime overweight status in relation to serial changes in body composition and risk factors for cardiovascular disease: The Fels Longitudinal Study. Obes Res 2000; 8: 422–430.

    CAS  Article  PubMed  Google Scholar 

  20. Sorensen MB, Rosenfalck AM, Hojgaard L, Ottesen B . Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy. Obes Res 2001; 9: 622–626.

    CAS  Article  PubMed  Google Scholar 

  21. Evans WJ . Exercise and nutritional needs of elderly people: effects on muscle and bone. Gerodontology 1998; 15: 15–24.

    CAS  Article  PubMed  Google Scholar 

  22. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20: 1183–1197.

  23. Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP . Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation 2000; 101: 975–980.

    CAS  Article  PubMed  Google Scholar 

  24. Wald NJ, Law M, Watt HC, Wu T, Bailey A, Johnson AM, Craig WY, Ledue TB, Haddow JE . Apolipoproteins and ischaemic heart disease: implications for screening [see comments]. Lancet 1994; 343: 75–79.

    CAS  Article  PubMed  Google Scholar 

  25. Kelley DE, Mandarino LJ . Hyperglycaemia normalizes insulin-stimulated skeletal muscle glucose oxidation and storage in noninsulin-dependent diabetes mellitus. J Clin Invest 1990; 86: 1999–2007.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  26. Lillioja S, Bogardus C, Mott DM, Kennedy AL, Knowler WC, Howard BV . Relationship between insulin-mediated glucose disposal and lipid metabolism in man. J Clin Invest 1985; 75: 1106–1115.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  27. Kunz I, Schorr U, Rommling K, Klaus S, Sharma AM . Habitual fat intake and basal fat oxidation in obese and non-obese Caucasians. Inte Relat Metab Disord 2002; 26: 150–156.

    CAS  Article  Google Scholar 

  28. Vasilaras TH, Raben A, Astrup A . Twenty-four hour energy expenditure and substrate oxidation before and after 6 months' ad libitum intake of a diet rich in simple or complex carbohydrates or a habitual diet. Int J Obes Relat Metab Disord 2001; 25: 954–965.

    CAS  Article  PubMed  Google Scholar 

  29. Samaras K, Kelly PJ, Campbell LV . Dietary underreporting is prevalent in middle-aged British women and is not related to adiposity (percentage body fat). Int J Obes Relat Metab Disord 1999; 23: 881–888.

    CAS  Article  PubMed  Google Scholar 

  30. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uustupa M Finish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–1350.

    CAS  Article  PubMed  Google Scholar 

Download references


This study was supported by the National Health and Medical Research Council of Australia. We wish to thank Joanna Edema and Lyn Croft for performing the metabolic assays, the nursing staff in the clinical facility at The Garvan Institute who assisted with clamp studies and the staff of the Nuclear Medicine Department, St Vincent's Hospital, who performed the DXA procedures. We especially thank the subjects who participated in the study.

Author information

Authors and Affiliations


Corresponding author

Correspondence to A M Poynten.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Poynten, A., Markovic, T., Maclean, E. et al. Fat oxidation, body composition and insulin sensitivity in diabetic and normoglycaemic obese adults 5 years after weight loss. Int J Obes 27, 1212–1218 (2003).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • weight loss
  • body composition
  • fasting glucose
  • fat oxidation
  • carbohydrate oxidation

Further reading


Quick links