Response to Comment on: Harte et al. High Fat Intake Leads to Acute Postprandial Exposure to Circulating Endotoxin in Type 2 Diabetic Subjects. Diabetes Care 2012;35:375–382

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The letter from Hansen et al. (1) raises an interesting question regarding the complexity of metabolic endotoxinemia and inflammation in vivo. Hansen et al. suggest endotoxin activity should induce an inflammatory response in our cohorts, as noted in a previous in vivo study, where healthy patients were inoculated with endotoxin (1,2). This has two elements to consider: firstly, the impact of endotoxin on inflammation in subjects, and secondly, the measurement of circulating endotoxin.