| Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. | |
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MedLine Citation:
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PMID: 20546255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Considerable data have accumulated over the past 20 years, indicating that the human kidney is involved in the regulation of glucose via gluconeogenesis, taking up glucose from the circulation, and by reabsorbing glucose from the glomerular filtrate. In light of the development of glucose-lowering drugs involving inhibition of renal glucose reabsorption, this review summarizes these data. Medline was searched from 1989 to present using the terms 'renal gluconeogenesis', 'renal glucose utilization', 'diabetes mellitus' and 'glucose transporters'. The human liver and kidneys release approximately equal amounts of glucose via gluconeogenesis in the post-absorptive state. In the postprandial state, although overall endogenous glucose release decreases substantially, renal gluconeogenesis increases by approximately twofold. Glucose utilization by the kidneys after an overnight fast accounts for approximately 10% of glucose utilized by the body. Following a meal, glucose utilization by the kidney increases. Normally each day, approximately 180 g of glucose is filtered by the kidneys; almost all of this is reabsorbed by means of sodium-glucose co-transporter 2 (SGLT2), expressed in the proximal tubules. However, the capacity of SGLT2 to reabsorb glucose from the renal tubules is finite and, when plasma glucose concentrations exceed a threshold, glucose appears in the urine. Handling of glucose by the kidney is altered in Type 2 diabetes mellitus (T2DM): renal gluconeogenesis and renal glucose uptake are increased in both the post-absorptive and postprandial states, and renal glucose reabsorption is increased. Specific SGLT2 inhibitors are being developed as a novel means of controlling hyperglycaemia in T2DM. |
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Authors:
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J E Gerich |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: 27 ISSN: 1464-5491 ISO Abbreviation: Diabet. Med. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-06-15 Completed Date: 2010-10-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: England |
Other Details:
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Languages: eng Pagination: 136-42 Citation Subset: IM |
Affiliation:
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University of Rochester School of Medicine, Rochester, NY 14642, USA. JOHNGERICH@compuserve.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Glucose
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metabolism* Diabetes Mellitus, Type 2 / metabolism*, urine Gluconeogenesis / physiology* Glucose / administration & dosage Homeostasis Humans Hyperglycemia / metabolism* Kidney / metabolism* Postprandial Period Sodium-Glucose Transporter 2 / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Sodium-Glucose Transporter 2; 50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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