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The regulation of glucose production uptake reabsorption and elimination is handled by several organs notably, the Pancreas and Liver.While traditionally not discussed is kidneys contribution to maintaining glucose homeostasis .It is multifaceted and include such functions as gluconeogenesis and glucose reabsorption . Latter being mediated by active ( sglt) and passive (glut) transporters.
Under normal circumstances , glucose filtered by glomeruli is completely reabsorbed, but in condition of hyperglycaemia or reduced absorptive capacity, glucosuria may occur. In hyperglycaemia , the kidneys may play an exacerbating role by reabsorbing excess glucose, ultimately contributing to chronic hyperglycaemia and subsequently Beta cell failure,insulin resistance and decreased glucose uptake. Hyperglycaemia in turn detrimentally affects the kidneys by damaging glomeruli ultimately causing microalbuminuria and nephropathy.
Knowledge of kidneys role in glucose homeostasis and the effect of glucose dysregulation on the kidneys is critical to optimal management of t2dm and prevention of renal complications.