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Diabetes 57:3-4, 2008
DOI: 10.2337/db07-1581
© 2008 by the American Diabetes Association
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Commentary

Diabetes and Protein Metabolism

Niels Møller1, and K. Sreekumaran Nair2

1 Medical Department M, Endocrinology and Diabetes, Aarhus University Hospital, Aarhus, Denmark
2 Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota

Address correspondence and reprint requests to Niels Møller, Medical Dep. M., Aarhus University Hospital, Medical Research Laboratories, Aarhus C 8000, Denmark. E-mail: nielsem@dadlnet.dk

The first 20% of the full text of this article appears below.

The celebrated Greek physician Aretaeus the Cappadocian some 1900 years ago described diabetes as a condition with "a melting down of the flesh and limbs into urine." Remarkably, his observations are amazingly durable and accurate even by the standards of today with reference to type 1 diabetes. For example, insulin deprivation in type 1 diabetic patients causes a profound increase in catabolism, especially in skeletal muscle (1–4). Moreover, this net muscle protein catabolism is due to a net increase in protein breakdown rather than a decline in protein synthesis (1–4). In contrast, despite substantial alterations in glucose and lipid metabolism, the effect of type 2 diabetes on changes in protein metabolism is at best subtle, and results are inconsistent (5–8). A key difference is that in type 1 diabetic patients on insulin deprivation, muscle mass withers away (as demonstrated by profound cachexia in type 1 diabetic patients during the preinsulin era), whereas no such dramatic changes occur in type 2 diabetic patients with poor glycemic control. Withdrawal of treatment for 10 days in type 2 diabetic patients had little effect on amino acid levels or protein metabolism (8), although glucose metabolism is substantially altered; this may . . . [Full Text of this Article]


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Copyright © 2008 by the American Diabetes Association.