ABSTRACT. Myo-inositol transport and metabolism were studied in cultured human skin fibroblasts exposed to potentially toxic levels of glucose or galactose. Although variable among I I different cell lines, the myo-inositol level in confluent cells, ranging from 10-50 nmol/mg protein, was constant with passage. A high-affinity transport system for myo-inositol had an apparent Kt of 55 pM and V, of 16 pmol/min/mg protein. No obvious relationship existed between cellular levels and transport capacity. Dependency on sodium was complex. When medium sodium was lowered to 23 mM, myo-inositol uptake ceased after about 1 h. However, the initial rate of myo-inositol uptake only showed a sodium dependence at low myo-inositol concentrations. Both phloretin and phloridzin inhibited myo-inositol uptake. Phloridzin had a Ki of 60 pM. and phloretin was either a noncompetitive or uncompetitive inhibitor. Glucose and galactose were only weak competitive inhibitors, with a K1 of 30 mM and 65 mM, respectively. After 24 h of incubation with myo-[2-3Hjinositol, only 10% of the total cell label was incorporated into phospholipid. Compared with control media with 5 mM glucose, the incubation of confluent cells in media with 20 mM glucose had little effect on intracellular glucose and sorbitol, whereas cells incubated in control media supplemented with 5 mM galactose showed a large increase in galactose and polyol levels. In media with more than 200 WM of myo-inositol, neither treatment had an effect on myo-inositol levels after 24 h. The uptake and incorporation of 11 pM myo-[2-3Hjinositol and incorporation into phospholipid were studied after cells had been previously exposed for 24 to 48 h to media supplemented with 15 mM glucose or galactose. Compared with controls, fibroblasts with a 24-h exposure to 20 m M glucose showed a 10% decrease in myo-inositol uptake. When the exposure was extended to 48 h, preconditioning with galactose as well as glucose elicited the same 10% reduction in uptake. Phosphoinositide labeling in fibroblasts exposed to 20 mM glucose was reduced in parallel. These cells offer a unique opportunity for the study of sugar toxicity in human tissue: they can be exposed to high levels of glucose without significant glucose or polyol accumulation~or can be made to accumulate polyol by exposure to moderate levels of galactose. The expression of a hexose-induced reduction in myo-inositol transport required 24 to 48 h of exposure of the fibroblasts to elevated concentrations of glucose or galactose and may not be related to a competitive inhibitory