Limitations to exercise- and maximal insulin-stimulated muscle glucose uptake

The hypothesis of this investigation was that insulin and muscle contraction, by increasing the rate of skeletal muscle glucose transport, would bias control so that glucose delivery to the sarcolemma (and t tubule) and phosphorylation of glucose intracellularly would exert more influence over glucose uptake. Because of the substantial increases in blood flow (and hence glucose delivery) that accompany exercise, we predicted that glucose phosphorylation would become more rate determining during exercise. The transsarcolemmal glucose gradient (TSGG; the glucose concentration difference across the membrane) is inversely related to the degree to which glucose transport determines the rate of glucose uptake. The TSGG was determined by using isotopic methods in conscious rats during euglycemic hyperinsulinemia [Ins; 20 mU/(kg . min); n = 7], during treadmill exercise (Ex, n = 6), and in sedentary, saline-infused rats (Bas, n = 13). Rats received primed, constant intravenous infusions of trace 3-O-[H-3]methyl-D-glucose and [U-C-14]mannitol. Then 2-deoxy-[H-3]glucose was infused for the calculation of a glucose metabolic index (R-g). At the end of experiments, rats were anesthetized, and soleus muscles were excised. Total soleus glucose concentration and the steady-state ratio of intracellular to extracellular 3-O[H-3]methyl-D-glucose (which distributes on the basis of the TSGG) were used to calculate ranges of possible glucose concentrations ([G]) at the inner and outer sarcolemmal surfaces ([G](im) and [CT](om), respectively). Soleus R-g was increased in Ins and further increased in Ex. In Ins, total soleus glucose, [G](om), and the TSGG were decreased compared with Bas, while [G](im) remained near 0. In Ex, total soleus glucose and [G](im) were increased compared with Bas, and there was not a decrease in [G](om) as was observed in Ins. In addition, accumulation of intracellular free 2-deoxy-[H-3]glucose occurred in soleus in both Ex and Ins. Taken together, these data indicate that, in Ex, glucose phosphorylation becomes an important limitation to soleus glucose uptake. In Ins, both glucose delivery and glucose phosphorylation influence the rate of soleus glucose uptake more than under basal conditions.