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. 2016 Apr 12;5:647. [Version 1] doi: 10.12688/f1000research.8299.1

Figure 11. Effects of shunting on normalized systemic insulin/GLP-1-dependent metabolism/glucose ratios.

Figure 11.

Panel 11A Opening the PSS resistance from 40 to 0.005 mm Hg.s ml -1, increases the normalized systemic insulin: glucose ratio to 2.1 in the fasting state (K ½ = 0.03 mm Hg.s ml -1) The normalized systemic insulin: glucose ratio increases as a hyperbolic function to maximum of 5.4 as shunt resistance falls ( K ½ = 0.03–0.04 mm Hg.s ml -1). Two peaks in the systemic insulin: glucose ratio (Figure 11A) The second smaller, longer lasting rise in the insulin/glucose ratio coincides with the second wave in hepatic gluconeogenesis/glucose ratio ( Figure 12E) ( K ½ = 0.06 mm Hg.s ml -1) and peripheral insulin-dependent metabolism ( K ½ = 0.015 mm Hg.s ml -1) (Figure 11D).

Panel 11B Opening the PSS increases GLP-1/glucose ratio as a hyperbolic function of shunt opening ( K ½ = 0.015 mm Hg.s ml -1) the ratio peaks 5 min after gavage, and thereafter decreases (t ½ = 2.5–3 min from the peak maximum).

Panel 11C Opening the PSS increases glucagon/glucose ratio as a hyperbolic function of shunt opening ( K ½ = 0.015 mm Hg.s ml -1) the ratio peaks 5.5 min after gavage, and thereafter decreases (t ½ = 3 min after the peak maximum). With a wide open shunt the glucagon/glucose ratio increases continuously during fasting owing to glucagon stimulated gluconeogenesis.

Panel 11D, GLP-1 and insulin interactively stimulate systemic glucose metabolism in insulin-sensitive tissues. Plots of the product of the normalized GLP-1. Insulin product/glucose peak 4.5 min after gavage. Shunting raises the GLP-1.insulin product 30-fold increase above that without shunting. The enhancement remains during the later digestive periods.

Panel 11E The normalized product of GLP-1*insulin in systemic blood increases as a hyperbolic function of PSS resistance. ( K ½ = 0.01 mm Hg.s ml -1to a maximum 30-fold above the level with without shunting 7 min after gavage; t ½ = 2.5–3 min from the peak maximum a residual increase remains throughout the later digestive phase. (K ½= 0.08 mm Hg.s ml -1).