Figure 3.

Insulin access is determined by i) vascular reactivity; ii) microcirculatory hemodynamics; and iii) capillary insulin permeability (determined by vesicular and/or paracellular fluid phase transport). Vascular reactivity and microcirculatory hemodynamics are determined by endocrine factors, paracrine factors, cytokines, and microcirculatory architecture. Capillary insulin efflux is determined by the balance between hydrostatic and oncotic pressures.