The stimulus-secretion coupling of glucose-induced insulin release. XX. fasting: a model for altered glucose...

The rate of glucose uptake and oxidation, the output of lactate, the net uptake of calcium, the release of preformed or newly synthesized insulin and, possibly to a lesser extent, the biosynthesis of proinsulin are all diminished in islets removed from fasted rats and exposed to glucose. Theophylline and dibutyryl-adenosine-3',5'-cyclic monophosphate fail to fully restore a normal secretory response to glucose, despite the fact that they increase lactate production by the islets from fasted animals. The insulinotropic action of other secretagogues, including glyceraldehyde, leucine, beta-hydroxybutyrate, and sulfonylurea is unaffected by prior fasting of the donor rats. The islets metabolism of glyceraldehyde is also unaffected by fasting. These data indicate that fasting is associated with a block in glucose metabolism in the early steps of glycolysis, prior to the triose-phosphate level, and suggest that the insulin secretory response to glucose may be closely dependent on the rate at which the hexose is metabolized by islet tissue.