This study will examine the effect of short term (14 day) very low calorie diet therapy (VLCD)(420 kCal/day) in patients with upper body obesity and NIDDM. Sensitivity to insulin will be evaluated by euglycemic hyperinsulinemic clamp with stable isotope tracer infusion and the sensitivity of adipose tissue to epinephrine will be studied before/after VLCD therapy. Adipose tissue TNF will be measured by Northern blot analysis of adipose tissue biopsies. We hypothesize VLCD therapy will increase sensitivity of adipose tissue to insulin, normalize sensitivity to epinephrine and reduce production of TNF alpha by adipose tissue.
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