Does insulin signalling decide glucose levels in the fasting steady state?

Recent work has suggested that altered insulin signalling may not be central to the pathophysiology of type 2 diabetes as classically believed. We critically re-examine the role of insulin in glucose homeostasis using five different approaches (i) systematic review and meta-analysis of tissue specific insulin receptor knock-outs, (ii) systematic review and meta-analysis of insulin suppression and insulin enhancement experiments, (iii) differentiating steady-state and post-meal state glucose levels in streptozotocin treated rats in primary experiments (iv) mathematical and theoretical considerations and (v) glucose insulin relationship in human epidemiological data. All the approaches converge on the inference that although insulin action is hastens the return to a steady-state after a glucose load, there is no evidence that insulin action determines the steady-state level of glucose. The inability to differentiate steady state causality from perturbed state causality has led to misinterpretation of the evidence for the role of insulin in glucose regulation.

• Publication year

  2019

• Venue

  bioRxiv

• Publication date

  2019-02-24

• Fields of study

  Biology, Medicine

• Identifiers
  DOI 10.1101/553016
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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