The lipogenic gene stearoyl-CoA desaturase (SCD)1 appears to be a promising new target for obesity-related diabetes, as mice deficient in this enzyme are resistant to diet-and leptin deficiency-induced obesity. The BTBR mouse strain replicates many features of insulin resistance found in humans with excess visceral adiposity. Using the hyperinsulinemic-euglycemic clamp technique, we determined that insulin sensitivity was improved in heart, soleus muscle, adipose tissue, and liver of BTBR SCD1-deficient mice. We next determined whether SCD1 deficiency could prevent diabetes in leptin-deficient BTBR mice. Loss of SCD1 in leptin ob/ob mice unexpectedly accelerated the progression to severe diabetes; 6-week fasting glucose increased ϳ70%. In response to a glucose challenge, Scd1 Ϫ/Ϫ leptin ob/ob mice had insufficient insulin secretion, resulting in glucose intolerance. A morphologically distinct class of islets isolated from the Scd1 Ϫ/Ϫ leptin ob/ob mice had reduced insulin content and increased triglycerides, free fatty acids, esterified cholesterol, and free cholesterol and also a much higher content of saturated fatty acids. We believe the accumulation of lipid is due to an upregulation of lipoprotein lipase (20-fold) and Cd36 (167-fold) and downregulation of lipid oxidation genes in this class of islets. Therefore, although loss of Scd1 has beneficial effects on adiposity, this benefit may come at the expense of -cells, resulting in an increased risk of diabetes. Diabetes 56:1228-1239, 2007 S tearoyl-CoA desaturase (SCD) catalyzes the synthesis of monounsaturated fatty acids by introducing a cis double bond in the ⌬9 position of saturated 16-and 18-carbon fatty acyl-CoA substrates. The products of SCD, palmitoleoyl-CoA and oleoylCoA, are the most abundant monounsaturated fatty acids of phospholipids, triglycerides, cholesterol esters, and wax esters (1). Various diseases, including cancer, obesity, diabetes, and atherosclerosis, are associated with an imbalance in the ratio of saturated to monounsaturated fatty acids (2). Two human and four mouse isoforms of SCD have been characterized. SCD1 is the primary isoform found in lipogenic tissues.Loss of Scd1 is protective against obesity (3-5). The decreased adiposity in the Scd1 Ϫ/Ϫ mice is due to reduced lipid synthesis and increased energy expenditure through enhanced fatty acid oxidation (3). Scd1 Ϫ/Ϫ mice have an increase in insulin signaling and glucose uptake in muscle and brown adipose tissue (6,7).Leptin-deficient BTBR leptin ob/ob mice are a particularly useful animal model for studying obesity-related diabetes. Unlike the B6 leptin ob/ob mice, which develop only moderate hyperglycemia, BTBR leptin ob/ob mice become severely diabetic (8 -10). The diabetic BTBR leptin ob/ob mice have increased Scd1 expression in muscle and decreased expression in adipose tissue and liver, compared with nondiabetic B6 leptin ob/ob mice (10). Insulin resistance is often correlated with abdominal obesity. The BTBR mouse strain has excess abdominal obesity associated with ins...