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Related Experiment Videos

Glucose allostasis.

Michael Stumvoll1, P Antonio Tataranni, Norbert Stefan

  • 1Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA. michael.stumvoll@med.uni-tuebingen.de

Diabetes
|March 29, 2003
PubMed
Summary
This summary is machine-generated.

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Glucose homeostasis is maintained by balancing insulin secretion and action. However, even with normal compensation, rising glucose levels indicate a physiological adaptation called glucose allostasis, which may lead to type 2 diabetes.

Area of Science:

  • Metabolic Physiology
  • Endocrinology
  • Diabetes Research

Background:

  • Normoglycemia relies on coupled insulin secretion (acute insulin response [AIR]) and insulin action (M).
  • Glucose homeostasis is often described by a hyperbolic relationship between AIR and M, assuming constant glucose levels.
  • It's hypothesized that AIR should not fully compensate for declining M to maintain a stimulus.

Purpose of the Study:

  • To investigate the relationship between insulin action and glucose levels under varying physiological conditions.
  • To introduce and define the concept of "glucose allostasis" as a physiological adaptation to chronic insulin resistance.
  • To examine the long-term consequences of this adaptation on glucose metabolism.

Main Methods:

  • Analysis of cross-sectional, longitudinal, and prospective data.

Related Experiment Videos

  • Inclusion of Pima Indian (n=413) and Caucasian (n=60) cohorts.
  • Assessment of fasting and postprandial glucose concentrations in relation to insulin action (M) and acute insulin response (AIR).

    • Main Results:

    • Fasting and postprandial glucose concentrations increase as insulin action (M) decreases, despite normal compensation of acute insulin response (AIR).
    • This observed phenomenon represents a physiological adaptation to chronic insulin resistance.
    • The data support the concept of glucose allostasis, where stability is achieved through physiological changes.

    Conclusions:

    • The study introduces "glucose allostasis" to describe the adaptive increase in glycemia during chronic insulin resistance.
    • Allostasis ensures continued homeostatic function under stress but incurs cumulative costs.
    • The "allostatic load" of increased glycemia may contribute to the development of type 2 diabetes over time.