Glucose, exercise and insulin: emerging concepts

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Abstract
Physical exercise induces a rapid increase in the rate of glucose uptake in the contracting skeletal muscles. The enhanced membrane glucose transport capacity is caused by a recruitment of glucose transporters (GLUT4) to the sarcolemma and t‐tubules. This review summarises the recent progress in the understanding of signals that trigger GLUT4 translocation in contracting muscle. The possible involvement of calcium, protein kinase C (PKC), nitric oxide (NO), glycogen and AMP‐activated protein kinase (AMPK) are discussed. Furthermore, the possible mechanisms behind the well‐described improvement of insulin action on glucose uptake and glycogen synthase activity in the post‐exercise period is discussed. It is concluded that both during and following muscle contractions, glycogen emerges as an important modulator of signalling events in glucose metabolism.