Renal glucose production and utilization: new aspects in humans
- M. StumvollAffiliated withMedizinische Universitätsklinik, Tübingen, Germany
- , C. MeyerAffiliated withUniversity of Rochester School of Medicine, Rochester, New York, USA
- , A. MitrakouAffiliated withAthens University, Athens, Greece
- , V. NadkarniAffiliated withUniversity of Rochester School of Medicine, Rochester, New York, USA
- , J. E. GerichAffiliated withUniversity of Rochester School of Medicine, Rochester, New York, USA
According to current textbook wisdom the liver is the exclusive site of glucose production in humans in the postabsorptive state. Although many animal and in vitro data have documented that the kidney is capable of gluconeogenesis, production of glucose by the human kidney in the postabsorptive state has generally been regarded as negligible. This traditional view is based on net balance measurements which, other than after a prolonged fast or during metabolic acidosis, showed no significant net renal glucose release. However, recent studies have refuted this view by combining isotopic and balance techniques, which have demonstrated that renal glucose production accounts for 25 % of systemic glucose production. Moreover, these studies indicate that glucose production by the human kidney is stimulated by epinephrine, inhibited by insulin and is excessive in diabetes mellitus. Since renal glucose release is largely, if not exclusively, due to gluconeogenesis, it is likely that the kidney is as important a gluconeogenic organ as the liver. The most important renal gluconeogenic precursors appear to be lactate, glutamine and glycerol. The implications of these recent findings on the understanding of the physiology and pathophysiology of human glucose metabolism are discussed. [Diabetologia (1997) 40: 749–757].
- Renal glucose production and utilization: new aspects in humans
Volume 40, Issue 7 , pp 749-757
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- Keywords Endogenous glucose production
- diabetes mellitus.
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