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Hence reabsorption of glucose is dependent upon the existing sodium gradient which is generated through the active functioning of the Na + /K +-ATPase. As the cotransport of glucose with sodium from the lumen does not directly require ATP hydrolysis but depends upon the action of the ATPase, this is described as secondary active transport.
Renal glucose reabsorption is the part of kidney (renal) physiology that deals with the retrieval of filtered glucose, preventing it from disappearing from the body through the urine. If glucose is not reabsorbed by the kidney, it appears in the urine, in a condition known as glycosuria. This is associated with diabetes mellitus. [1]
In August 1960, in Prague, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for intestinal glucose absorption. [17] Crane's discovery of cotransport was the first-ever proposal of flux coupling in biology. [18] [19]
If the RTG is so low that even normal blood glucose levels produce the condition, it is referred to as renal glycosuria. Glucose in urine can be identified by Benedict's qualitative test. If yeast is present in the bladder, the sugar in the urine may begin to ferment, producing a rare condition known as urinary auto-brewery syndrome.
By reducing glucose blood circulation, gliflozins cause less stimulation of endogenous insulin secretion or lower dose of exogenous insulin that results in diabetic ketoacidosis. They can specifically cause euglycemic DKA (euDKA, DKA where the blood sugar is not elevated) because of the renal tubular absorption of ketone bodies. [13]
SGLT2 is located in the early proximal tubule, and is responsible for reabsorption of 80-90% of the glucose filtered by the kidney glomerulus. [7] Most of the remaining glucose absorption is by sodium/glucose cotransporter 1 (SGLT1) in more distal sections of the proximal tubule. [8]
Conversely, glycogenesis is enhanced and glycogenolysis inhibited when there are high levels of insulin in the blood. [15] The level of circulatory glucose (known informally as "blood sugar"), as well as the detection of nutrients in the Duodenum is the most important factor determining the amount of glucagon or insulin produced.
Insulin, which lowers blood sugar, and glucagon, which raises it, are the most well known of the hormones involved, but more recent discoveries of other glucoregulatory hormones have expanded the understanding of this process. The gland called pancreas secretes two hormones and they are primarily responsible to regulate glucose levels in blood. [1]