Figure 2.

Impaired mitochondrial bioenergetics causes dysregulations in insulin and glucagon secretion. The increased glucose uptake during high plasma glucose concentration causes the acceleration of glycolytic and mitochondrial metabolism. Due to mitochondrial dysfunction (md), the aerobic ATP production rate (J_ATP,aerobic) and subsequent absolute ATP concentration are reduced, causing insufficient decrease of K_ATP conductance and impaired effects on the VDCC. As the glucose dependency of glucagon and insulin secretion is severely impacted. Green arrows represent a response to the rise in glucose under normal physiological conditions, and red arrows represent a lack of response due to mitochondrial dysfunction.