Insulin Clearance in Obesity and Type 2 Diabetes

2022/01/06 by Han‐Chow E. Koh, Chao Cao, Bettina Mittendorfer · 1 citation
Medicine · #Adipose Tissue and Metabolism #Diabetes, Cardiovascular Risks, and Lipoproteins #Adipokines, Inflammation, and Metabolic Diseases

paper · pdf · doi:10.3390/ijms23020596

openalex publication_date 2022/01/06 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

Plasma insulin clearance is an important determinant of plasma insulin concentration. In this review, we provide an overview of the factors that regulate insulin removal from plasma and discuss the interrelationships among plasma insulin clearance, excess adiposity, insulin sensitivity, and type 2 diabetes (T2D). We conclude with the perspective that the commonly observed lower insulin clearance rate in people with obesity, compared with lean people, is not a compensatory response to insulin resistance but occurs because insulin sensitivity and insulin clearance are mechanistically, directly linked. Furthermore, insulin clearance decreases postprandially because of the marked increase in insulin delivery to tissues that clear insulin. The commonly observed high postprandial insulin clearance in people with obesity and T2D likely results from the relatively low insulin secretion rate, not an impaired adaptation of tissues that clear insulin.

Citations

• Insulin Degradation: Progress and Potential*
• The incretin effect in healthy individuals and those with type 2 diabetes: physiology, pathophysiology, and response to therapeutic interventions
• Insulin resistance drives hepatic de novo lipogenesis in nonalcoholic fatty liver disease
• Obesity Is Associated With Increased Basal and Postprandial β-Cell Insulin Secretion Even in the Absence of Insulin Resistance
• Early beta cell dysfunction vs insulin hypersecretion as the primary event in the pathogenesis of dysglycaemia
• β Cell function and plasma insulin clearance in people with obesity and different glycemic status

Cited by

• Insulin [wikipedia]

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