Integrated Roles of Glucoregulatory Hormones during Postprandial, Postabsorptive, and Stress States of Metabolism: A Review

  • Benjamin Kambiz Ghiam Oakland University William Beaumont School of Medicine
  • Stephanie Swanberg Oakland University William Beaumont School of Medicine
  • Suzan ElSayed Oakland University William Beaumont School of Medicine
Keywords: Blood glucose, homeostasis, physiology, hormones, postprandial, postabsorptive, stress


This review describes the roles of the regulatory and counter-regulatory hormones that are involved in the physiological regulation of blood glucose. Dysfunction in the regulatory processes of blood glucose underlies the fundamental pathology seen in both type 1 and type 2 diabetes mellitus, the major cause of heart disease and stroke in the world and an estimated total medical cost of $245 billion annually. Previous studies that have reviewed the physiology of glucose homeostasis have not detailed the interplay between the regulatory hormones and their roles in stimulating or inhibiting the key metabolic enzymes during the various stages of metabolism, including the prandial, post-absorptive, prolonged fasting, and stress states.  In addition, previous studies have not described the roles of additional hormones that are recently understood to be essential to blood glucose regulation, including the hormones amylin and irisin. This review describes the sequelae of hormonal changes, their enzymatic regulation, and subsequent metabolic changes that function to either increase or decrease blood glucose levels to ultimately restore euglycemia during these various stages of metabolism. Moreover, many of the hormones detailed in this review, as well as the metabolic enzymes and processes they regulate, are emerging targets for pharmaceutical intervention in patients with both type 1 and type 2 diabetes mellitus. In order to further the understanding of the pathophysiology underlying diabetes mellitus as well as potential future targets for pharmaceutical therapy, the extensive and integrated roles of glucoregulatory hormones that dominate the postprandial, post-absorptive, and stress states of metabolism are examined.

Author Biographies

Stephanie Swanberg, Oakland University William Beaumont School of Medicine

Stephanie M. Swanberg, MSI, AHIP

Oakland University William Beaumont School of Medicine

Department of Biomedical Sciences

Suzan ElSayed, Oakland University William Beaumont School of Medicine

Suzan El Sayed, DVM, PhD

Oakland University William Beaumont School of Medicine

Department of Biomedical Sciences


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