Low Dose Fat-Induced Insulin Resistance

Eligibility Criteria

• * Subjects who are able to provide written informed consent and to comply with the procedures of the study protocol
• * History of diabetes
• * History of diabetes in more than one first-degree relative
• * Body mass index (BMI) \<19 or \>27 kg/m2
• * HbA1c \>5.7%
• * Blood Pressure: systolic \>160 mmHg or diastolic \> 100 mmHg
• * Baseline hemoglobin concentration \< 11 g/dl in women and \< 12 g/dl in men
• * Estimated glomerular filtration rate \< 55 ml/min/1.73 m2 (calculated using the subject's measured serum creatinine and the Modification of Diet in Renal Disease \[MDRD\] study estimation formula).
• * Presence of soy or egg allergies (due to possible reactions with fat infusate)
• * For female participants: Positive pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures for the duration of the study. Oral contraceptives, Norplant®, Depo-Provera®, and barrier devices with spermicide are acceptable contraceptive methods; condoms used alone are not acceptable.
• * Known active alcohol or substance abuse
• * Use of tobacco within the previous year
• * Severe co-existing cardiac disease, characterized by any one of these conditions:
• 1. history of myocardial infarction within past 6 months;
• 2. history of ischemia on functional cardiac exam within the last year;
• 3. history of left ventricular ejection fraction \< 30%.
• * Persistent elevation of liver function tests \> 1.5 times normal upper limits
• * Hyperlipidemia (fasting LDL cholesterol \> 130 mg/dl, treated or untreated; and/or fasting triglycerides \> 200 mg/dl)
• * Receiving treatment for a medical condition requiring chronic use of systemic steroids, except for the use of ≤ 5 mg prednisone daily, or an equivalent physiological dose of hydrocortisone
• * Presence of a seizure disorder
• * Use of any investigational agents within 4 weeks of enrollment
• * Any medical condition, which in the opinion of the investigator, will interfere with the safe completion of the study
• * History of pancreatitis
• * Presence of a metal allergy (aluminum)