Pulsatile insulin the Medicare NCD will continue to remain in effect. Pulsatile insulin Pulsatile intravenous insulin therapy, sometimes called metabolic activation therapy, or cellular activation therapy describes in a literal sense the intravenous injection of insulin in pulses versus continuous infusions. Injection of insulin in pulses mimics the physiological secretions of insulin by the pancreas into the portal vein which then drains into the liver. In healthy, non-diabetic individuals, pancreatic secretions of insulin correspond to the intake of food. The pancreas will secrete variable amounts of insulin based upon the amount of food consumed (basically speaking, the more food that is consumed,
Insulin signal transduction pathway region called Islets of Langerhans. In the islets of Langerhans, there are beta-cells, which are responsible for production and storage of insulin. Insulin is secreted as a response mechanism for counteracting the increasing excess amounts of glucose in the blood. Glucose in the body increases after food consumption. This is primarily due to carbohydrate intake, but to a much lesser degree protein intake ()(). Depending on the tissue type, the glucose enters the cell through facilitated or passive diffusion. In muscle and adipose tissue, glucose enters through GLUT 4 receptors via facilitated diffusion (). In brain, kidney and retina, glucose