Cited by 323Diabetes, Cardiovascular Risks, and LipoproteinsMetabolism, Diabetes, and CancerDiabetes Management and Research

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The vascular actions of insulin control its delivery to muscle and regulate the rate-limiting step in skeletal muscle insulin action

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Barrett, E. J., Eggleston, E. M., Inyard, A. C., Wang, H., Li, G., Chai, W., Liu, Z.·2009·Diabetologia

DOI 10.1007/s00125-009-1313-zPMC PMC2704146

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Abstract

Evidence suggests that insulin delivery to skeletal muscle interstitium is the rate-limiting step in insulin-stimulated muscle glucose uptake and that this process is impaired by insulin resistance. In this review we examine the basis for the hypothesis that insulin acts on the vasculature at three discrete steps to enhance its own delivery to muscle: (1) relaxation of resistance vessels to increase total blood flow; (2) relaxation of pre-capillary arterioles to increase the microvascular exchange surface perfused within skeletal muscle (microvascular recruitment); and (3) the trans-endothelial transport (TET) of insulin. Insulin can relax resistance vessels and increase blood flow to skeletal muscle. However, there is controversy as to whether this occurs at physiological concentrations of, and exposure times to, insulin. The microvasculature is recruited more quickly and at lower insulin concentrations than are needed to increase total blood flow, a finding consistent with a physiological role for insulin in muscle insulin delivery. Microvascular recruitment is impaired by obesity, diabetes and nitric oxide synthase inhibitors. Insulin TET is a third potential site for regulating insulin delivery. This is underscored by the consistent finding that steady-state insulin concentrations in plasma are approximately twice those in muscle interstitium. Recent in vivo and in vitro findings suggest that insulin traverses the vascular endothelium via a trans-cellular, receptor-mediated pathway, and emerging data indicate that insulin acts on the endothelium to facilitate its own TET. Thus, muscle insulin delivery, which is rate-limiting for its metabolic action, is itself regulated by insulin at multiple steps. These findings highlight the need to further understand the role of the vascular actions of insulin in metabolic regulation.

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Authors: Barrett, E. J., Eggleston, E. M., Inyard, A. C., Wang, H., Li, G., Chai, W., & Liu, Z.
Affiliations: University of Virginia Health System (US)
Corresponding author: Barrett, E. J.
ORCID: Barrett, E. J.
Inyard, A. C.
Chai, W.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2009-03-13
Volume: 52
Issue: 5
Pages: 752-764
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-009-1313-z
PMC: PMC2704146
OpenAlex: W2033746638
Semantic Scholar: 1734beade6892acf92cbb3b6f1dfe6b7bf05b1ef
Cited by: 323
References: 97
Citations by year: 2026: 12 · 2025: 7 · 2024: 9 · 2023: 9 · 2022: 14 · 2021: 19 · 2020: 13 · 2019: 18 · 2018: 10 · 2017: 19 · 2016: 15 · 2015: 20 · 2014: 19 · 2013: 51 · 2012: 29
FWCI: 3.85
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: University of Virginia
University College London
Vrije Universiteit Amsterdam
National Institutes of Health (5p30dk063609-05, RR-00847)
National Institute of Diabetes and Digestive and Kidney Diseases (DK073759, R01DK073759, DK057878, DK-063609, P30-DK-063609, R01DK057878)
National Center for Research Resources (RR 00847, M01RR000847)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: insulin, skeletal muscle, insulin delivery, resistance vessels, blood flow, insulin resistance, nitric oxide synthase, obesity, diabetes mellitus, muscle glucose uptake, endothelium
MeSH terms: Animals, Glucose, Homeostasis, Humans, Hyperinsulinism, Insulin, Insulin Resistance, Kinetics, Microcirculation, Glucose Clamp Technique, Microdialysis, Muscle, Skeletal

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The vascular actions of insulin control its delivery to muscle and regulate the rate-limiting step in skeletal muscle insulin action

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