Acta Diabetologica

, Volume 55, Issue 2, pp 205–207 | Cite as

Impact of variations in duodenal glucose load on insulin clearance in health and type 2 diabetes

  • Chinmay S. MaratheEmail author
  • Christopher K. Rayner
  • Karen L. Jones
  • Michael Horowitz
Short Communication


Up to 70% of secreted insulin is degraded or cleared prior to entering the systemic circulation, primarily in the liver which represents an important mechanism in the regulation of glucose homeostasis [1]. Insulin clearance is known to be reduced following oral, compared with intravenous, glucose administration; however, the mechanism is incompletely understood. Variations in insulin clearance may contribute to the ‘incretin’ effect (IE), which accounts for 50–70% of postprandial insulin release in health and is markedly reduced in type 2 diabetes (T2D). Hence, the incretin effect reflects not only an amplified insulin secretory response (ISR), but also reduced insulin clearance, to oral compared with isoglycemic intravenous glucose [2].

After the meal, the stomach regulates the delivery of chyme to the small intestine, at a rate that exhibits wide inter-individual variation—between 1 and 4 kcal/min in health, with an even wider range in diabetes, where patients often have...



Funding was provided by the National Health and Medical Research Council, Australia (Grant No. 627139).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2017

Authors and Affiliations

  • Chinmay S. Marathe
    • 1
    • 2
    Email author
  • Christopher K. Rayner
    • 1
    • 2
  • Karen L. Jones
    • 1
    • 2
  • Michael Horowitz
    • 1
    • 2
  1. 1.Discipline of Medicine, The University of AdelaideRoyal Adelaide HospitalAdelaideAustralia
  2. 2.Centre of Research Excellence in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaideAustralia

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