title: Regulation of microvascular flow and metabolism: An overview.
abstract: Skeletal muscle is an important site for insulin to regulate blood glucose levels. It is estimated that skeletal muscle is responsible for ~80% of insulin-mediated glucose disposal in the post-prandial period. The classical action of insulin to increase muscle glucose uptake involves insulin binding to insulin receptors on myocytes to stimulate glucose transporter 4 (GLUT 4) translocation to the cell surface membrane, enhancing glucose uptake. However, an additional role of insulin that is often under-appreciated is its action to increase muscle perfusion thereby improving insulin and glucose delivery to myocytes. Either of these responses (myocyte and/or vascular) may be impaired in insulin resistance, and both impairments are apparent in type 2 diabetes, resulting in diminished glucose disposal by muscle. The aim of this review is to report on the growing body of literature suggesting that insulin-mediated control of skeletal muscle perfusion is an important regulator of muscle glucose uptake and that impairment of microvascular insulin action has important physiological consequences early in the pathogenesis of insulin resistance. This work was discussed at the 2015 Australian Physiological Society Symposium "Physiological mechanisms controlling microvascular flow and muscle metabolism".
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Michelle A
authors: MA
authors: Keske
authors: School of Medicine, University of Tasmania, Hobart, Tas., Australia.
authors: Renee M
authors: RM
authors: Dwyer
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Ryan D
authors: RD
authors: Russell
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Sarah J
authors: SJ
authors: Blackwood
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Aascha A
authors: AA
authors: Brown
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Donghua
authors: D
authors: Hu
authors: School of Medicine, University of Tasmania, Hobart, Tas., Australia.
authors: Dino
authors: D
authors: Premilovac
authors: School of Medicine, University of Tasmania, Hobart, Tas., Australia.
authors: Stephen M
authors: SM
authors: Richards
authors: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia.
authors: Stephen
authors: S
authors: Rattigan
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008833:Microcirculation / Q000502:physiology*; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000378:metabolism*; D012039:Regional Blood Flow / Q000502:physiology*
keywords: blood flow; insulin action; insulin resistance