Epinephrine and b-adrenergic stimulation rapidly inhibit insulin-mediated glucose uptake by induction of insulin resistance mainly in the skeletal muscle [1,2]. The insulin signalling pathway may be altered by b-adrenergic stimulation both by cAMP and cAMP independent mechanisms [3]. An inhibitory action at multiple sites is suggested since the insulin signal is disturbed at the receptor level [4] as well as in the tyrosine kinase [5], the glucose transporter protein [6] and the glycolytic pathway [7]. Moreover, induction of lipolysis by b-adrenergic stimuli leads to decreased oxidation of glucose through the action of the Randle cycle [8].The glucose transporter protein is considered to be rate-limiting for insulin-stimulated glucose uptake in the muscle. Moreover, recent research has emphasized the importance of the capillary wall as a major determinant of the transendothelial delivery of glucose [9] and insulin [10] in skeletal muscle since the interstitial concentrations of glucose and insulin are lower than those in the arterial plasma [9,10]. This is further supported by the findings that the insulin-[11] and glucose-[12] stimulated increase in muscle blood flow correlates with glucose uptake in normal as well as in insulin resistant muscles [13].The importance of blood flow for the rate of delivery of glucose and insulin to the muscles is, however, Diabetologia (1998) Summary Muscle glucose uptake and lactate release during b-adrenergic stimulation by epinephrine (epi) and b-adrenergic blockade by propranolol (prop) were investigated during an euglycaemic hyperinsulinaemic (30 pmol × kg ±1 × min ±1 ) with or without added somatostatin (0.1 mg/min; pancreatic) clamp in female rats. To assess the interstitial insulin, glucose and lactate concentrations, microdialysis was done in the medial femoral muscle in both legs. The influence of muscle skeletal blood flow on interstitial insulin, glucose and lactate was examined with the microsphere technique, using 57 Co-microspheres. Epinephrine decreased glucose infusion rate by about 75 % (p < 0.0001) and increased concentrations of interstitial glucose by about 35 % (p < 0.001) and lactate by about 65 % (p < 0.01). Plasma insulin concentration increased during b-adrenergic stimulation by about 25 % (p < 0.05) whereas the interstitial insulin concentration was unchanged. Muscle blood flow in the hindlimb was considerably enhanced by about 130 %, (p < 0.001) by epinephrine. Infusion of propranolol totally abolished all the above effects induced by epinephrine. The data show that insulin resistance and vasodilation induced by b-adrenergic stimulation with epinephrine is accompanied by increased interstitial glucose as well as lactate concentrations in muscle. The increased interstitial glucose concentration is the result of a decreased cellular uptake of glucose together with an increased capillary delivery of glucose by vasodilation. It is concluded that the severe cellular resistance to insulin induced by epinephrine could not be overcome either by the increased...