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. 2021 Jun 4;8:654557. doi: 10.3389/fmed.2021.654557

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Copyright © 2021 Provenzano, Pelle, Zaffina, Tassone, Pujia, Ricchio, Serra, Sciacqua, Michael, Andreucci and Arturi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Central role of the kidney in glucose metabolism. The kidneys intervene in glucose homeostasis regulation through three main mechanisms: the glucose reabsorption via sodium co-transporters (SGLTs), the gluconeogenesis with endogenous glucose production and the utilization of glucose. The right side of the figure shows the mechanism of sodium and glucose reabsorption through the SGLT and GLUT transporters in the kidney. SGLTs, which are mainly located on the brush border (luminal side) of epithelial tubular cells, enables the transfer of both sodium and glucose from the lumen into the tubular cells. Sodium is transported along with glucose through the SGLTs. Next, glucose enters blood circulation through an active transport mechanism mediated by GLUTs, which are located on the basolateral membrane of the epithelial tubular cells. Sodium is actively exchanged between tubular cells and blood circulation through a Na+/K+/ATPase pump. The different phases of renal gluconeogenesis and glycolysis are depicted on the left side of the figure.