This is a single-center, prospective, randomized, controlled (crossover) clinical study
designed to investigate the specific dose-response impact of insulin infusion rate (IIR) on
blood glucose levels during a pancreatic clamp study. The investigators will recruit
participants with a history of overweight/obesity and prediabetic state (i.e., prediabetes or
impaired fasting glucose, with fasting hyperinsulinemia), with evidence of, or clinically
judged to be at high risk for, uncomplicated non-alcoholic fatty liver disease (NAFLD).
Participants will undergo two pancreatic clamp procedures in which individualized basal IIR
are identified, followed in one by maintenance of basal IIR (maintenance hyperinsulinemia,
MH) and in the other by a stepped decline in IIR (reduction toward euinsulinemia, RE). In
both clamps the investigators will closely monitor plasma glucose and various metabolic
parameters. The primary outcome will be the absolute and relative changes in steady-state
plasma glucose levels at each stepped decline in IIR.