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Insulin is a protein hormone. Its mature form has two polypeptide chains; identifying their sequences and protein disulfide bonds provided the motivating example in Sanger's insulin sequencing experiment. See Cooper: insulin as a two-chain hormone, figure 2.16.

A meal illustrates the insulin side of blood glucose homeostasis: rising glucose stimulates beta cells in the pancreatic islets, and released insulin favors uptake and storage of fuel. Alpha cells produce glucagon, while delta cells produce somatostatin, which inhibits release of both insulin and glucagon. The pancreas therefore contains interacting sensor and secretory biological cells, rather than one undifferentiated source of hormones. ^[ref]

Insulin and glucagon are peptide hormones, built from amino acid residues joined by peptide bonds; glucose is a small carbohydrate molecule. A hormone changes signal transduction, not the identity of the fuel it regulates. Human mature insulin has 51 amino acid residues in two polypeptide chains. Beta cells process proinsulin to insulin and C-peptide, storing the products in secretory granules for exocytosis. Increased glucose metabolism raises the ATP-to-ADP ratio, tending to close ATP-sensitive potassium channels; depolarization and entry of calcium ions then trigger exocytosis. This is an important triggering pathway, with additional amplification and modulatory inputs.^[ref]

Binding to the insulin receptor, a receptor tyrosine kinase, starts phosphorylation of the receptor and insulin receptor substrates. Recruitment of phosphoinositide 3-kinase and activation of Akt transmit a major metabolic branch. In skeletal muscle and adipose tissue, that branch helps move GLUT4 to the cell membrane, increasing glucose uptake by facilitated diffusion. GLUT4 is a membrane transport protein, not an insulin receptor. Insulin also favors glycogenesis in skeletal muscle and the liver, and inhibits lipolysis in adipose tissue. In the liver, suppression of glucose output involves enzyme regulation, gene expression, and indirect changes in substrate supply. Its relative direct and indirect contributions are more complex than a single Akt arrow. ^[ref]

Insulin is not a universal permission slip for glucose entry: red blood cells and much of the nervous system use uptake mechanisms that are not acutely dependent on insulin. Nor does the liver use the same GLUT4 switch as skeletal muscle. This is why reduced insulin action can change blood glucose dramatically without stopping all glucose uptake. ^[ref]

Diabetes can disrupt production, response, and counterregulation. Type 1 diabetes usually involves destruction of beta cells and severe loss of endogenous insulin; type 2 diabetes combines insulin resistance with insufficient beta cell compensation. High circulating insulin can therefore coexist with impaired insulin action. Inappropriate glucagon release can add to excessive liver glucose output, and the response to low blood glucose can also be impaired: "more glucagon" is not a complete description of diabetes. These distinctions explain mechanisms, rather than prescribe treatment. ^{[ref] [ref]}

Phospholipase C catalyzes hydrolysis of membrane PIP2, producing soluble IP3 and membrane-associated diacylglycerol. This consumes a phospholipid substrate, rather than manufacturing calcium. G protein-regulated and receptor tyrosine kinase-regulated forms of PLC provide different routes to this reaction.^[ref]

A protein kinase is an enzyme that catalyzes phosphorylation of a protein. In receptor tyrosine kinase signaling, ATP supplies the transferred phosphate group.

A receptor tyrosine kinase combines extracellular ligand recognition with an intracellular protein kinase protein domain. A membrane-spanning segment connects these parts across the cell membrane: the signal changes the intracellular machinery without requiring the ligand to enter the cytosol. The protein kinase transfers a phosphate group from ATP to selected tyrosine residues on proteins, including the receptor itself.^[ref]

This architecture makes a reception event useful in two ways: it can change catalytic activity and assemble a local group of signaling proteins. Trans-autophosphorylation can create phosphotyrosine residues recognized by SH2 domains. Recruitment positions a downstream enzyme or relay protein near its partners. Neither every modified site nor every recruited protein has the same effect; association is a specific molecular connection, rather than a universal command to activate everything nearby.^[ref]

Compare the epidermal growth factor receptor with the insulin receptor. Their common topology does not impose one activation geometry or make assembly equivalent to activity. The receptor phosphorylation assay consequently needs more than evidence that two protein chains associate.

A tyrosine residue is an amino acid residue whose amino acid side chain can accept a phosphate group during receptor tyrosine kinase signaling. The conventional one-letter sequence symbol is $Y$.