Maturity Onset Diabetes of the Young-type 3 (MODY-3)has been linked to mutations in the transcription factor hepatic nuclear factor (HNF)-1␣, resulting in deficiency in glucose-stimulated insulin secretion. In INS-1 cells overexpressing doxycycline-inducible HNF-1␣ dominant-negative (DN-) gene mutations, and islets from Hnf-1␣ knock-out mice, insulin secretion was impaired in response to glucose (15 mM) and other nutrient secretagogues. Decreased rates of insulin secretion in response to glutamine plus leucine and to methyl pyruvate, but not potassium depolarization, indicate defects specific to mitochondrial metabolism. To identify the biochemical mechanisms responsible for impaired insulin secretion, we used 31 P NMR measured mitochondrial ATP synthesis (distinct from glycolytic ATP synthesis) together with oxygen consumption measurements to determine the efficiency of mitochondrial oxidative phosphorylation. Mitochondrial uncoupling was significantly higher in DN-HNF-1␣ cells, such that rates of ATP synthesis were decreased by approximately one-half in response to the secretagogues glucose, glutamine plus leucine, or pyruvate. In addition to closure of the ATP-sensitive K ؉ channels with mitochondrial ATP synthesis, mitochondrial production of second messengers through increased anaplerotic flux has been shown to be critical for coupling metabolism to insulin secretion. 13 C-Isotopomer analysis and tandem mass spectrometry measurement of Krebs cycle intermediates revealed a negative impact of DN-HNF-1␣ and Hnf-1␣ knock-out on mitochondrial second messenger production with glucose but not amino acids. Taken together, these results indicate that, in addition to reduced glycolytic flux, uncoupling of mitochondrial oxidative phosphorylation contributes to impaired nutrient-stimulated insulin secretion with either mutations or loss of HNF-1␣.Mutations in the transcription factor hepatic nuclear factor (HNF) 2 -1␣ in pancreatic -cells are responsible for impaired glucose-stimulated insulin secretion (GSIS) in patients with Maturity Onset Diabetes of the Young-type 3 (MODY-3) (1-5). Of the numerous mutations in the HNF-1␣ gene associated with MODY-3, all of which negatively affect DNA binding and/or transactivation (6), the p291fsinsC frameshift mutation is the most common (7). This study also employed the dominant-negative SM6 construct that displays a very similar phenotype to p291fsinsC, both in cell lines and when expressed in the -cells of transgenic mice (7-10). Studies of rat insulinoma INS-1 cells engineered with doxycycline-inducible expression of these DN-HNF-1␣ genes have shown that its expression impacts the mRNA and protein levels of several gene products integral to glycolytic and mitochondrial energy production (7,8). Specifically, expression of the GLUT2 transporter, aldolase B, and L-type pyruvate kinase is decreased in these cells (7,8), as well as in islets from mice expressing the DN-HNF-1␣ (9) or loss of Hnf-1␣ (5). Mitochondrial targets identified in the dominant-negative mutations in the HNF...