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We examined the relationship between peripheral/hepatic insulin sensitivity and abdominal superficial/deep subcutaneous fat (SSF/DSF) and intra-abdominal visceral fat (VF) in patients with type 2 diabetes mellitus (T2DM). Sixty-two T2DM patients (36 males and 26 females, age = 55 ± 3 yr, body mass index = 30 ± 1 kg/m²) underwent a two-step euglycemic insulin clamp (40 and 160 mU · m⁻² · min⁻¹) with [3-³H]glucose. SSF, DSF, and VF areas were quantitated with magnetic resonance imaging at the L_4–5 level. Basal endogenous glucose production (EGP), hepatic insulin resistance index (basal EGP × FPI), and total glucose disposal (TGD) during the first and second insulin clamp steps were similar in male and female subjects. VF (159 ± 9 vs. 143 ± 9 cm²) and DSF (199 ± 14 vs. 200 ± 15 cm²) were not different in male and female subjects. SSF (104 ± 8 vs. 223 ± 15 cm²) was greater (P < 0.0001) in female …