Because of the demonstration of a genetic linkage between glucokinase and Type II diabetes, and the central role of glucokinase on glucose metabolism, we studied glucokinase activity in the liver of patients with and without Type II diabetes. Glucokinase activity was decreased by about 50% in obese subjects with diabetes (n = 12) compared with (p < 0.01) lean controls (n = 9) and (p < 0.05) obese controls (n = 10). There was no difference between lean and obese controls. Fifty percent of subjects with diabetes had lower liver glucokinase activity than the lowest value of the controls. These data further support the important role that glucokinase plays in the pathogenesis of Type II diabetes.