Hormonal
In non-insulin-dependent diabetes mellitus (NIDDM), skeletal muscle exhibits impaired free fatty acid (FFA) utilization and oxidation during both fasting and postprandial states, characterized by reduced fractional extraction and uptake of oleate in the fasting state and a failure to suppress FFA uptake after meal ingestion.
If you have type 2 diabetes, your muscles are less efficient at burning fat for energy, especially when you haven't eaten, and they fail to slow down fat uptake after you eat. This isn't because your muscle structure is broken, but because high blood sugar and insulin resistance are forcing your body to burn more glucose and store more fat. Managing blood glucose levels is critical to restoring normal fat oxidation.
In summary, during postabsorptive conditions there is reduced utilization of FFA by muscle, while during postprandial conditions there is impaired suppression of FFA uptake across the leg in NIDDM. During both fasting and postprandial conditions, NIDDM subjects have reduced rates of lipid oxidation by muscle.
Why this rating
The study uses rigorous leg balance methods and indirect calorimetry on a controlled cohort, providing strong physiological evidence, though it is observational regarding the mechanism (not an intervention trial).
Source
Impaired free fatty acid utilization by skeletal muscle in non-insulin-dependent diabetes mellitus.
David E. Kelley et al. · Journal of Clinical Investigation · 1994
DOI 10.1172/jci117600
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