Visualise the effects of insulin on the liver

The hormone insulin does not work as well with the onset of type 2 diabetes and with fatty liver disease. Normally, insulin ensures that sugars are absorbed into tissues (especially muscle and liver). Insulin also ensures that the liver no longer delivers sugars to the blood. Due to these two factors, insulin keeps blood sugar levels low. A reduced insulin sensitivity therefore contributes to an increased blood sugar level. The muscle is especially important in the absorption of sugars, but the liver plays a role in both absorption and release of sugars. However, when studying the “insulin sensitivity of the liver”, usually only the release of sugar is considered (the reduction of the glucose release from the liver due to insulin); this aspect is measured with a so-called "clamp" technique in which insulin and glucose are infused into test subjects.

However, to study the first aspect, sugar uptake in the liver, other techniques are needed; it is proposed to investigate this sugar uptake in the liver by taking measurements of glucose uptake over time with a PET scanner (ie “dynamic” PET measurements). By combining dynamic PET measurements with the clamp technique, the metabolism of the liver can be visualised much more completely and it can be better understood what goes wrong in people with fatty liver disease and/or type 2 diabetes. This knowledge is needed to be able to improve the health of the liver in the future in people with fatty liver disease and diabetes. In this project these measurement procedures are set up and apply them in people with a lot or a little liver fat. This way there will be received as complete a picture as possible of the liver metabolism and this enables to study what changes occur with fatty liver.