Myriad mysteries of glucose homeostasis

Excerpt

In our bodies, glucose metabolism is maintained in an amazingly elaborate manner, in both postprandial and fasting states, than ever previously imagined. The widely used continuous glucose monitoring system has revealed that a not inconsiderable population with normal glucose tolerance shows slight fluctuations in glucose levels even after eating. We believe that insulin is secreted by pancreatic β cells in response to blood glucose elevation, resulting in lowering of blood glucose to normal levels. That is to say, based on this mechanism, insulin secretion is stimulated AFTER blood glucose elevation. In a portion of normal subjects, however, blood glucose elevation would not initially occur even after food intake. Thus, glucose-stimulated insulin secretion cannot, by itself, explain these observations. Therefore, I have come to believe that there must be predictive and preventive mechanisms which function prior to blood glucose elevation. …