Insulin regulates glucose uptake into fat and muscle by modulating the subcellular distribution of GLUT4 between the cell surface and intracellular compartments. However, quantification of these translocation processes in muscle by classical subcellular fractionation techniques is confounded by contaminating microfibrillar protein; dynamic studies at the molecular level are almost impossible. In this study, we introduce a musclespecific transgenic mouse model in which HA-GLUT4-GFP is expressed under the control of the MCK promoter. HA-GLUT4-GFP was found to translocate to the plasma membrane and T-tubules after insulin stimulation, thus mimicking endogenous GLUT4. To investigate the dynamics of GLUT4 trafficking in skeletal muscle, we quantified vesicles containing HA-GLUT4-GFP near the sarcolemma and T-tubules and analyzed insulin-stimulated exocytosis at the single vesicle level by total internal reflection fluorescence and confocal microscopy. We found that only 10% of the intracellular GLUT4 pool comprised mobile vesicles, whereas most of the GLUT4 structures remained stationary or tethered at the sarcolemma or T-tubules. In fact, most of the insulin-stimulated exocytosis emanated from pretethered vesicles, whereas the small pool of mobile GLUT4 vesicles was not significantly affected by insulin. Our data strongly suggest that the mobile pool of GLUT4 vesicles is not a major site of insulin action but rather locally distributed. Most likely, pretethered GLUT4 structures are responsible for the initial phase of insulin-stimulated exocytosis.hemagglutinin; glucose transporter 4; green fluorescent protein; insulin; fusion MUSCLE, ESPECIALLY SKELETAL MUSCLE, is a major direct contributor to mammalian systemic glucose homeostasis (1, 10). It is now well established that insulin stimulates glucose transport in adipose and muscle cells through the translocation of glucose transporter 4 (GLUT4) from intracellular sites to the plasma membrane (5, 13, 15). However, whereas the molecular mechanism of GLUT4 translocation has been extensively studied in primary adipose cells and cultured adipocytes during the past years, relatively few studies have focused on GLUT4 trafficking in primary skeletal muscle cells (18,20). In part, this is due to the presence of abundant microfibrillar protein and large amounts of nuclei such that most fractionation protocols suffer from poor resolution for the analysis of the subcellular distribution of GLUT4 in skeletal muscle. Likewise, because of technical limitations, morphological analyses of GLUT4 in skeletal muscle by photolabeling techniques, immunofluorescence, and electron microscopy have not provided sufficient information about the kinetics and dynamics of GLUT4 recycling through the multiple intracellular compartments.Recent alternative approaches involving ectopic expression of tagged glucose transporters in culture cells offer novel opportunities for the molecular analysis of GLUT4 translocation (9,11,35). In these studies, recombinant GLUT4 reporters carrying extracellular ep...