During the flow phase, the glucagon-to-insulin ratio is typically:

• A. Low
• B. High
• C. Normal
• D. Variable

Answer: (B)

In the flow phase the body is in a catabolic, stress-driven state where energy needs are met by mobilizing glucose and fats. Counterregulatory hormones such as glucagon, epinephrine, cortisol, and growth hormone are elevated, driving hepatic glucose production through gluconeogenesis and glycogenolysis and promoting lipolysis. Insulin, on the other hand, is not rising to the same extent due to insulin resistance and counterregulatory effects. The result is a glucagon-to-insulin ratio that is high. This high ratio supports increased glucose output and substrate mobilization to meet acute energy demands, which is why it’s typical of the flow phase.