Editorial Research Support, N.I.H., Extramural Ppublish 19 citations
PubMed: 33813879 DOI: 10.1152/ajpendo.00628.2020
Importance of the route of insulin delivery to its control of glucose metabolism.
Am J Physiol Endocrinol Metab 320(5):E891-E897
Authors: Dale S Edgerton, Mary C Moore, Justin M Gregory, Guillaume Kraft, Alan D Cherrington
Affiliations
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee.
Abstract
Pancreatic insulin secretion produces an insulin gradient at the liver compared with the rest of the body (approximately 3:1). This physiological distribution is lost when insulin is injected subcutaneously, causing impaired regulation of hepatic glucose production and whole body glucose uptake, as well as arterial hyperinsulinemia. Thus, the hepatoportal insulin gradient is essential to the normal control of glucose metabolism during both fasting and feeding. Insulin can regulate hepatic glucose production and uptake through multiple mechanisms, but its direct effects on the liver are dominant under physiological conditions. Given the complications associated with iatrogenic hyperinsulinemia in patients treated with insulin, insulin designed to preferentially target the liver may have therapeutic advantages.
MeSH
Endocrinology, Insulin, Fatty Acids, Nonesterified, Liver, Hyperinsulinism, Glucagon
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