RT Journal
T1 Glucose and insulin: A chicken or egg problem
JF JAMA
JO JAMA
YR 1969
FD December 8
VO 210
IS 10
SP 1914
OP 1914
DO 10.1001/jama.1969.03160360060014
UL http://dx.doi.org/10.1001/jama.1969.03160360060014
AB Does glucose control insulin, or does insulin control glucose? It all depends, as we shall see.Long before reliable methods for measuring circulating insulin were available, it was assumed that the familiar shape of the normal glucose tolerance curve was determined by a spurt of insulin secretion evoked by the hyperglycemia of glucose administration, and subsiding as the blood glucose fell after reaching its peak. The development and application of the immunoassay for insulin appeared to confirm this concept. On this basis, a reasonable view of the train of events would be: glucose load→hyperglycemia→ insulin secretion→limitation of glucose rise (peak) and trend toward normoglycemia→diminishing insulin secretion. Graphically, blood glucose and plasma insulin in the normal situation run parallel courses, but functionally they may change hats as the minutes go by. Certainly glucose is initially the prime mover of insulin; a little later, it would appear, insulin acts as the prime