Modeling the insulin-glucose feedback system: the significance of pulsatile insulin secretion.

A mathematical model of the insulin-glucose feedback regulation in man is used to examine the effects of an oscillatory supply of insulin compared to a constant supply at the same average rate. We show that interactions between the oscillatory insulin supply and the receptor dynamics can be of minute significance only. It is possible, however, to interpret seemingly conflicting results of clinical studies in terms of their different experimental conditions with respect to the hepatic glucose release. If this release is operating near an upper limit, an oscillatory insulin supply will be more efficient in lowering the blood glucose level than a constant supply. If the insulin level is high enough for the hepatic release of glucose to nearly vanish, the opposite effect is observed. For insulin concentrations close to the point of inflection of the insulin-glucose dose-response curve an oscillatory and a constant insulin infusion produce similar effects.