Energy balance
In well-controlled type 2 diabetes, muscle mitochondrial ATP synthetic flux is reduced and fails to increase in response to insulin stimulation, independent of glucose transport/phosphorylation rates.
For individuals with well-controlled Type 2 Diabetes, standard insulin therapy may not fully restore muscle mitochondrial efficiency (ATP production) compared to healthy individuals, even if blood sugar is managed. This suggests that focusing solely on glucose levels might miss underlying mitochondrial inefficiencies. Prioritizing physical activity and managing lipid availability (via diet) may help support mitochondrial function, as these factors were identified as key determinants of ATP flux in this population.
Patients with well-controlled T2DM feature slightly lower flux through muscle ATP synthesis, which occurs independently of glucose transport /phosphorylation and lipid deposition but is determined by lipid availability and insulin sensitivity.
Why this rating
Small sample size (n=31) but rigorous methodology (MRS, clamps) and clear statistical significance.
Source
Muscle Mitochondrial ATP Synthesis and Glucose Transport/Phosphorylation in Type 2 Diabetes
Julia Szendroedi et al. · PLoS Medicine · 2007
DOI 10.1371/journal.pmed.0040154
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