A comprehensive view of muscle glucose uptake: regulation by insulin, contractile activity, and exercise.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic physiological and molecular evidence without systematic review methodology.
PubMed 40173020 · doi:10.1152/physrev.00033.2024
What was done
This narrative review synthesizes molecular and physiological mechanisms governing skeletal muscle glucose uptake. The authors examine glucose transit across capillary walls into interstitial space, the molecular pathways directing GLUT4 translocation to the sarcolemma and T tubules in response to insulin and muscle contraction, the impact of physical activity versus inactivity on insulin sensitivity, and sex differences in glucose metabolism.
What was found
The abstract provides no quantitative data. It reports that GLUT4 translocation across the muscle cell membrane is the primary rate-limiting step in glucose uptake, storage, and utilization under most conditions. It notes that while core regulatory pathways are established, recent cellular, animal, and human omics studies demonstrate a high level of molecular signaling complexity.
Why it matters
Understanding the distinct signaling cascades that drive muscle glucose uptake during feeding and exercise clarifies how physical activity maintains metabolic health and informs targets for treating insulin resistance.
Limits
The review does not employ a systematic literature search or quantitative meta-analysis. Much of the detailed signaling architecture relies on in vitro and animal models, and the abstract explicitly notes that translatability of these experimental findings to intact human physiology remains to be validated.
Cited by
- supports Physical activity stimulates glucose transporters and allows muscles to take up glucose directly without requiring insulin.