Insulin oscillation blood from the pancreas to the liver, which is a major insulin target. Disturbances of the insulin oscillations occur early in type 2 diabetes and may contribute to insulin resistance. Pulsatile insulin delivery to the portal vein or islet cell transplantation to the liver of diabetic patients are therefore attractive therapeutic alternatives. Insulin oscillation The insulin concentration in blood increases after meals and gradually returns to basal levels during the next 1–2 hours. However, the basal insulin level is not stable. It oscillates with a regular period of 3-6 min. After a meal the amplitude of these oscillations increases but
Pulsatile insulin blood into the liver in variable amounts, closely related to ingestion of meals. For induction and maintenance of insulin-dependent enzymes essential for glucose metabolism in the liver (e.g. hepatic glucokinase, phosphofructokinase, and pyruvate kinase), the hepatocytes require a defined insulin level (200-500 µU/ml in the portal vein) concomitant with high glucose levels (which acts as a bimolecular signal). In non-diabetic subjects, portal insulin concentrations are twofold to threefold greater than those in the peripheral circulation. During the first pass through the liver, 50% of the insulin is removed, strongly insinuating that the liver is the principal metabolic target organ of