basal state which represents a clear departure from the response in clinical studies where overnight fasting FFAs were consistently lowered by tesaglitazar [28–30]. One possible explanation may be the relatively short treatment duration in the current study. In response to PPARγ agonists adipose tissue undergoes cellular remodeling [41], with large insulin resistant fat cells emptying and newly differentiated cells filling with triglycerides before a new steady state is reached. Prior to achieving this new steady state it may be that fasting insulin levels which fall in response to developing treatment induced whole body insulin sensitization are insufficient to normalize FFA release from adipose tissue. In patients with type 2 diabetes, for example, approximately 6 weeks of treatment is required for tesaglitazar to achieve the full glucose lowering effect [30].
