Effect of Angiotensin Receptor Blockade on Insulin Resistance and Adipose Tissue Cytokines in Type 2 Diabetes

10-15 patients with type 2 diabetes and 10-15 healthy control subjects will be examined on an outpatient basis. The following examination will be carried out in each subject after 12 hrs fasting:

• Oral glucose tolerance test (75 g of glucose) (in healthy subjects to confirm the normal tolerance of glucose).
• Evaluation of insulin secretion after 1 mg of glucagon i.v.
• Hyperinsulinaemic (75 milly-international unit(mIU)/l) euglycemic clamp study lasting 4 hours combined with indirect calorimetry and biopsy of subcutaneous adipose tissue.
• Hyperinsulinemic (75 mIU/l) euglycemic clamp study lasting 4 hours combined with indirect calorimetry after losartan 100 mg given in the evening and in the morning before the study.
• Proton and phosphorus magnetic resonance spectroscopy.

Before (0 min), at 30 min and in the end of studies c) and d) the blood samples will be taken and biopsies of subcutaneous abdominal adipose tissue will be done.

Inclusion criteria

• Type 2 Diabetes treated with oral agents and/or diet
• Healthy volunteers age- and sex-matched to type 2 diabetes, without any concomitant disease

Exclusion criteria

• Type 2 Diabetes

• treated with insulin
• clinical evidence of atherosclerotic complications
• advanced long-term diabetic complications (manifest nephropathy, proliferative retinopathy)
• other internal disease
• weight change >10% 3 months prior to study
• Healthy volunteers

• fulfilling the criteria of metabolic syndrome
• weight change >10% 3 months prior to study