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Insulin Resistance in Type 2 Diabetes and L-Carnitine

Diabetes mellitus is a chronic condition in which the body does not produce or does not use insulin effectively. It is not simply hyperglycemia, or too much glucose (sugar) in the blood. Ninety percent of individuals with diabetes have type 2 (NIDDM, non-insulin independent diabetes). Most of these individuals are over 40 years old. Heart disease is the leading cause of diabetes-related deaths, with adults having two to four times higher heart disease death rates than adults without the disease. Patients with diabetes develop more atherosclerosis (hardening of the arteries) than people without diabetes, and some 60-65 percent of patients with diabetes have high blood pressure.

L-Carnitine is an amino acid that is naturally produced in the body and plays a vital role in the metabolism of fat. It functions as a transporter of fatty acids into the mitochondria. L-carnitine helps the body produce energy. L-carnitine is effective in treating and preventing L-carnitine deficiency and increasing red blood cell count in people with serious kidney disease.

A recent study sought to evaluate the effects of adding L-carnitine to the treatment of type 2 diabetes. The study included 254 patients with uncontrolled (HbA1c > 8%) type 2 diabetes. The patients were randomized to receive either 10 mg sibutramine plus 2 g L-carnitine or 10 mg sibutramine alone. Researchers measured several markers which included body weight, BMI HbA1c, fasting plasma glucose, post-prandial plasma glucose and cholesterol levels in each of the participants at baseline, and after 3, 6, 9 and 12 months. At the conclusion of the trial, researchers found that both groups had significant decreases in body weight, BMI and HbA1c. It was also discovered that the addition of L-carnitine to sibutramine gave faster improvements of cholesterol levels, insulin resistance profiles, glycemic control and body weight than treatment with just sibutramine alone. These results suggest that sibutramine is an effective treatment option, but the addition of L-carnitine can help accelerate the beneficial results in adults with uncontrolled type 2 diabetes.1

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This article was published on Monday November 22, 2010.
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Derosa G, Maffioli P, Salvadeo, et al. Sibutramine and L-carnitine compared to sibutramine alone on insulin resistance in diabetic patients. Intern Med. 2010;49(16):1717-25.