Role of the endocrine system in maintaining glucose homeostasis in health and disease
This paper highlights fundamental views on the mechanisms of maintaining glucose homeostasis as these mechanisms are explained in the lectures on diabetes. The authors discuss hormonal mechanisms of glycemic regulation after meal and fasting, biochemical processes of lipid, protein, and carbohydrate metabolism, and their relationships to maintain energy balance under normal conditions. The role of insulin as the important anabolic hormone stimulating ATP synthesis in a cell and endogenous energy accumulation in liver and muscle glycogen, and neutral lipids, the primary energy substrate, is described. In addition, insulin affects DNA and RNA synthesis via the pentose phosphate pathway and 6-ribulose 5-phosphate, allowing for endogenous protein synthesis in protein malnutrition. The effects of contrainsular hormones supplying the body with energy under starvation (i.e., glucagon and catecholamines, which stimulate glycogenolysis, and glucocorticoids that stimulate gluconeogenesis, thereby maintaining normal blood glucose levels) are described in detail. Furthermore, the paper uncovers the mechanism of switching from carbohydrate metabolism to lipid metabolism mediated by somatotropin to preserve energy balance. Finally, the mechanisms of hyperglycemia in insulin deficiency and the appearance of clinical signs of diabetes and other endocrine disorders are addressed. KEYWORDS: carbohydrate metabolism, glucose, glucose transporters, glycolysis, glycogenolysis, gluconeogenesis, lipolysis. FOR CITATION: Nedosugova L.V. Role of the endocrine system in maintaining glucose homeostasis in health and disease. Russian Medical Inquiry. 2021;5(9):586–591 (in Russ.). DOI: 10.32364/2587-6821-2021-5-9-586-591.