This study examined the relationship between transcapillary insulin-transport and insulin action in vivo. During euglycemic clamps (n = 7) in normal conscious dogs we simultaneously measured plasma and thoracic duct lymph insulin and glucose utilization (Rd). Clamps consisted of an activation phase with constant insulin infusion (0.6 mU/kg per min) and a deactivation phase. 14CIInulin was infused as a passively transported control substance. While [14Cjinulin reached an equilibrium between plasma and lymph, steady-state (ss) plasma insulin was higher than lymph (P < 0.05) and the ratio of 3:2 was maintained during basal, activation, and deactivation phases: 18±2 vs. 12±1, 51±2 vs. 32±1, and 18±3 vs. 13±1 ,U/ml. In addition, it took longer for lymph insulin to reach ss than plasma insulin during activation and deactivation: 11±2 vs.31±5 and 8±2 vs. 32±6 min (P < 0.02). Rd increased from 2.6±0.1 to a ss of 6.6±0.4 mg/kg per min within 50±8 min. There was a remarkable similarity in the dynamics of insulin in lymph and Rd: the time to reach ss for Rd was not different from lymph insulin (P > 0.1), and the relative increases of the two measurements were similar, 164±45% and 189±29% (P > 0.05). While there was only a modest correlation (r = 0.78, P < 0.01) between Rd and plasma insulin, the dynamic changes of lymph insulin and Rd showed a strong correlation (r = 0.95, P < 0.01). The intimate relationship between lymph insulin and Rd suggests that the transcapillary insulin transport is primarily responsible for the delay in Rd. Thus, transcapillary transport may be rate limiting for insulin action, and if altered, it could be an important component of insulin resistance in obesity and diabetes mellitus.