Role of lipids in development of noninsulin-dependent diabetes mellitus: lessons learned from Pima Indians.

We studied the role of lipids in the pathogenesis of noninsulin-dependent diabetes mellitus (NIDDM) in Pima Indians. High plasma levels of nonesterified fatty acid (NEFA) predicted development of NIDDM, but this effect cannot entirely be explained by the glucose-fatty acid cycle. Dyslipidemia, although often associated with diabetes, did not seem to predict NIDDM and might rather be associated with, or the consequence of insulin resistance. In some individuals, a single amino acid substitution in the intestinal fatty acid binding protein could result in increased rates of intestinal absorption of dietary NEFA and thereby contribute to increased lipid-oxidation rates and insulin resistance.