Abstract
Markedly increased cholesterol synthesis and low absorption of cholesterol in our obese patients with type 2 diabetes (1) prompted Dr. Ertel (2) to question whether the “succinate hypothesis” could explain the changes in cholesterol metabolism. According to the succinate mechanism, summarized by Fahien and MacDonald (3), a basic requirement for insulin release would be the generation of mevalonic acid. This would be regulated by insulinotropic action of succinate and other nutrient secretagogues through several intracellular metabolic …
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