Physiology of Glucose: An Updated Review for Healthcare Professionals

Alhajrasi, Hanadi Naji; Alanazi, Maryam Helal Rasheed; Alanizi, Hamoud Ghayyadh; Almutairi, Amal Khalifah; Al-Rashudi, Khaled Abdul Rahman Suleiman; Alahmari, Khalid Saeed Oudah; Hayjan, Saad Abdulrazaq  Ahmed; Alshehri, Meshal Mahdi Abdulrahman; Alhefdhi, Shatha Ahmed; Bakri, Mohammed Ali Ibrahim; Saleh, Wafa Saadullah; Alhazmi, Anan Homoud; Alajlan, Ali Abdullah Mohammed; Alanazi, Ahmad Asri Awad; Alharbi, Adel Lafi; Alharbi, Bander Nasser; Al-Azmi, Naif Abdulrahman; Ahmed, Ohud Ahmed; Hayjan, Saad  Abdulrazaq  Ahmed

doi:10.21608/ejchem.2025.405197.12065

	Physiology of Glucose: An Updated Review for Healthcare Professionals
Egyptian Journal of Chemistry
Volume 68, Issue 13, December 2025, Pages 1175-1184 PDF (628.09 K)
Document Type: Review Articles
DOI: 10.21608/ejchem.2025.405197.12065
Authors
Hanadi Naji Alhajrasi¹; Maryam Helal Rasheed Alanazi¹; Hamoud Ghayyadh Alanizi¹; Amal Khalifah Almutairi¹; Khaled Abdul Rahman Suleiman Al-Rashudi¹; Khalid Saeed Oudah Alahmari²; Saad Abdulrazaq Ahmed Hayjan^* ²; Meshal Mahdi Abdulrahman Alshehri²; Shatha Ahmed Alhefdhi²; Mohammed Ali Ibrahim Bakri¹; Wafa Saadullah Saleh¹; Anan Homoud Alhazmi¹; Ali Abdullah Mohammed Alajlan¹; Ahmad Asri Awad Alanazi¹; Adel Lafi Alharbi¹; Bander Nasser Alharbi¹; Naif Abdulrahman Al-Azmi¹; Ohud Ahmed Ahmed²; Saad Abdulrazaq Ahmed Hayjan¹
¹Ministry of National Guard, Saudi Arabia
²King Khalid University Hospital, Saudi Arabia
Abstract
Background: Glucose is the dominant carbohydrate fuel that supports cellular respiration, with availability sustained by coordinated digestion, intestinal absorption, hepatic processing, storage as glycogen, and regulated tissue uptake. Disruption of these processes produces clinically significant dysglycemia. Aim: To synthesize contemporary physiological concepts of glucose handling across molecular, cellular, and organ-system levels, and to link these mechanisms to diagnostic testing and clinical states relevant to healthcare practice. Methods: Narrative integration of established mechanisms of glucose metabolism (glycolysis, tricarboxylic acid cycle, oxidative phosphorylation), storage dynamics, transporter biology (SGLT/GLUT families), endocrine regulation (insulin and counter-regulatory hormones), and standard glycemic tests (FBG, RBG, OGTT), with pathophysiologic correlates. Results: Glucose flux is determined by (1) cellular pathways converting glucose to ATP under anaerobic and aerobic conditions; (2) storage–mobilization cycles governed by insulin–glucagon signaling; (3) tissue-specific transport via SGLTs and GLUT isoforms, notably insulin-responsive GLUT-4; and (4) organ axes—liver, pancreas, adrenal, thyroid, and anterior pituitary—that integrate nutrient and stress cues. Diagnostic assays (FBG, RBG, OGTT) characterize fasting and dynamic regulation, enabling detection of impaired tolerance and diabetes. Perturbations manifest as type 1 diabetes (autoimmune insulin deficiency), type 2 diabetes (insulin resistance with β-cell dysfunction), reactive and fasting hypoglycemia, and metabolic syndrome. Chronic hyperglycemia drives micro- and macrovascular complications; acute crises include hyperosmolar hyperglycemic state, while hypoglycemia endangers neurocognitive function. Conclusion: Glucose homeostasis emerges from tightly coupled transport, enzymatic, and endocrine controls. Understanding these interactions improves risk stratification, testing choices, and targeted interventions across the dysglycemia spectrum
Keywords
glucose physiology; glycogen; SGLT; GLUT-4; insulin; glucagon; gluconeogenesis

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