Metabolomic Analysis of Hepatic Insulin Resistance

Study start date: April 1, 2013

Inclusion Criteria: Subjects eligible to participate in the study will be: Adults over age 18; Patients enrolled in the bariatric surgery clinic who are planning to undergo and have insurance approval for bariatric surgery; Insulin sensitive (based on HOMA-IR calculated from screening labs) OR insulin resistant (based on HOMA-IR and or personal history of diet controlled diabetes) Able and willing to give informed consent. Exclusion Criteria The following will exclude subjects from study participation: Clinically significant medical issues outside of diabetes (eg, pregnancy, cardiovascular disease, uncontrolled pulmonary disease). If female and of child bearing potential, a pregnancy test will be performed and confirmed negative prior to participation in the study and prior to the scheduled glucose clamp procedure. A history of hematologic (platelets <100 x107/L), hepatic (liver function tests [LFTs] >2X upper limit of normal), renal (Creatinine >1.5 mg/dL), pulmonary/ cardiac abnormalities (ie, abnormal electrocardiogram [EKG]). Use of anti-diabetes medication, anticoagulants, or medication that might alter lipids. If the subject has a history of diabetes, it should be controlled by diet alone. Inflammatory or celiac intestinal disease; Untreated thyroid disease; Excessive alcohol use, illicit drug use, or active untreated psychiatric disease.