| Outcome Measures: |
Primary: Changes in unfolded protein response markers, Changes in unfolded protein response markers in adipose tissue biopsy samples. Specifically, the investigators will determine changes in mRNA (by RT-PCR) and protein (by Western blots) levels of the following ER stress markers: GRP78, ATF4, XBP-1s, PDI, calreticulin and calnexin., baseline, 6 months, 9 months | Secondary: Insulin sensitivity, Changes in insulin resistance will be determined by measuring changes in total body glucose uptake and in plasma free fatty acid (FFA) levels during euglycemic-hyperinsulinemic clamping., baseline, 3 months, 6 months and 9 months|Glucose control, Glucose control will be assessed by monthly A1c determinations., baseline, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months|Energy expenditure, Changes in energy expenditure will be assessed by indirect calorimetry, baseline, 3 months, 6 months, 9 months|Body weight, Patients will be weighed monthly, baseline, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months|Body composition, Body composition will be determined using bioelectrical impedance., baseline, 3 months, 6 months and 9 months|Beta cell function, Subjects will undergo an oral glucose tolerance tests(OGTT) to assess beta cell function., baseline, 6 months, 9 months
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