During a high-dose intravenous infusion of a mixed MCT/LCT-lipid emulsion and a conventional LCT-emulsion respectively, muscle substrate metabolism was investigated using the human forearm technique. With both lipid emulsions, a decrease in fractional muscular glucose extraction was seen, leading to significantly reduced muscular glucose uptake rates. An inverse linear relation between arterial tree fatty acids supply and fractional glucose extraction was seen suggesting that a mechanism according to Randle's glucose fatty acid concept is operating in skeletal muscle in man.