American Diabetes Association
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The Importance of the Mechanisms by which Insulin Regulates Meal-Associated Liver Glucose Uptake in the Dog

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posted on 2021-03-23, 22:28 authored by Guillaume Kraft, Katie C. Coate, Marta Smith, Ben Farmer, Melanie Scott, Alan D. Cherrington, Dale S. Edgerton
Hepatic glucose uptake (HGU) is critical for maintaining normal postprandial glucose metabolism. Insulin is clearly a key regulator of HGU, but the physiologic mechanisms by which it acts have yet to be established. This study sought to determine the mechanisms by which insulin regulates liver glucose uptake under postprandial-like conditions (hyperinsulinemia, hyperglycemia, and a positive portal vein to arterial glucose gradient). Portal vein insulin infusion increased hepatic insulin levels 5-fold in healthy dogs. In one group (n=7), the physiologic response was allowed to fully occur, while in another (n=7), insulin’s indirect hepatic effects, occurring secondary to its actions on adipose tissue, pancreas, and brain, were blocked. This was accomplished by infusing triglyceride (intravenous), glucagon (portal vein), and inhibitors of brain insulin action (intracerebroventricular) to prevent decreases in plasma free fatty acids or glucagon, while blocking increased hypothalamic insulin signaling for 4h. In contrast to the indirect hepatic effects of insulin, which were previously shown capable of independently generating a half-maximal stimulation of HGU, direct hepatic insulin action was by itself able to fully stimulate HGU. This suggests that under hyperinsulinemic/hyperglycemic conditions insulin’s indirect effects are redundant to direct engagement of hepatocyte insulin receptors.


This work was funded by NIH R01DK018243. Hormone analysis was performed by Vanderbilt’s Hormone Assay and Analytical Services Core, supported by DK059637 and DK020593.