The relation between plasma glucose and insulin release from pancreatic beta-cells is not stationary in the sense that a given
glucose concentration leads to a specific rate of insulin secretion. A number of time-dependent mechanisms appear to exist
that modify insulin release both on a short and a longer time scale. Typically, two phases are described. The first phase,
lasting up to 10 min, is a pulse of insulin release in response to fast changes in glucose concentration. The second phase
is a more steady increase of insulin release over minutes to hours, if the elevated glucose concentration is sustained. The
paper describes the glucose sensing mechanism via the complex dynamics of the key enzyme glucokinase, which controls the first
step in glucose metabolism: phosphorylation of glucose to glucose-6-phosphate. Three time-dependent phenomena (mechanisms)
are described. The fastest, corresponding to the first phase, is a delayed negative feedback regulating the glucokinase activity.
Due to the delay, a rapid glucose increase will cause a burst of activity in the glucose sensing system, before the glucokinase
is down-regulated. The second mechanism corresponds to the translocation of glucokinase from an inactive to an active form.
As the translocation is controlled by the product(s) of the glucokinase reaction rather than by the substrate glucose, this
mechanism gives a positive, but saturable, feedback. Finally, the release of the insulin granules is assumed to be enhanced
by previous glucose exposure, giving a so-called glucose memory to the beta-cells. The effect depends on the insulin release
of the cells, and this mechanism constitutes a second positive, saturable feedback system. Taken together, the three phenomena
describe most of the glucose sensing behaviour of the beta-cells. The results indicate that the insulin release is not a precise
function of the plasma glucose concentration. It rather looks as if the beta-cells just increase the insulin production, until
the plasma glucose has returned to normal. This type of integral control has the advantage that the precise glucose sensitivity
of the beta-cells is not important for normal glucose homeostasis.
Key words glucose metabolism - glucose sensing - glucokinase - translocation - time-dependent mechanisms - glucose memory - pancreatic beta-cell - first phase - insulin release - mathematical modelling