Key result
Insulin exerts at least three separate actions on the peripheral vasculature, with its action on the precapillary arteriole likely playing the dominant role in mediating muscle glucose metabolism.
This review proposes a framework to resolve controversies regarding insulin's vascular actions by recognizing its distinct effects on different parts of the peripheral vasculature.
Does not alter glycemic management; leaves open prospective validation of precapillary arteriole dominance in insulin-mediated glucose uptake.
Whether a discrete vascular action of insulin in skeletal muscle integrally participates in insulin-mediated glucose disposal has been extensively examined but remains a contentious issue. Here, we review some of the data both supporting and questioning the role of insulin-mediated increases in limb blood flow in glucose metabolism. We advance the hypothesis that controversy has arisen, at least in part, from a failure to recognize that insulin exerts at least three separate actions on the peripheral vasculature, each with its own characteristic dose and time responsiveness. We summarize how, viewed in this manner, certain points of contention can be resolved. We also advance the hypothesis that an action on the precapillary arteriole may play the dominant role in mediating perfusion-dependent effects of insulin on glucose metabolism in muscle.
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Clerk et al. (2003) conducted a review in Insulin-mediated glucose disposal. Insulin was evaluated. Insulin exerts at least three separate actions on the peripheral vasculature, with its action on the precapillary arteriole likely playing the dominant role in mediating muscle glucose metabolism.
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