Journal
DIABETES
Volume 58, Issue 2, Pages 448-452Publisher
AMER DIABETES ASSOC
DOI: 10.2337/db08-1224
Keywords
-
Categories
Funding
- Juvenile Diabetes Research Foundation Center for the Study of Hypoglycemia [4-2004-807]
- Yale Center of Clinical Investigation
- National Institutes of Health [R37-DK-20495, ULI-RR-024139, P30-DK-45735]
Ask authors/readers for more resources
OBJECTIVE-The hypothalamus is the central brain region responsible for sensing and integrating responses to changes in circulating glucose. The aim of this study was to determine the time sequence relationship between hypothalamic activation and the initiation of the counterregulatory hormonal response to small decrements in systemic glucose. RESEARCH DESIGN AND METHODS-Nine nondiabetic volunteers underwent two hyperinsulinemic clamp sessions in which pulsed arterial spin labeling was used to measure regional cerebral blood flow (CBF) at euglycemia (similar to 95 mg/dl) on one occasion and as glucose levels were declining to a nadir of similar to 50 mg/dl on another occasion. Plasma glucose and counterregulatory hormones were measured during both study sessions. RESULTS-CBF to the hypothalamus significantly increased when glucose levels decreased to 77.2 +/- 2 mg/dl compared with the euglycemic control session when glucose levels were 95.7 +/- 3 mg/dl (P = 0.0009). Hypothalamic perfusion was significantly increased before there was a significant elevation in counterregulatory hormones. CONCLUSIONS-Our data suggest that the hypothalamus is exquisitely sensitive to small decrements in systemic glucose levels in healthy, nondiabetic subjects and that hypothalamic blood flow, and presumably neuronal activity, precedes the rise in counterregulatory hormones seen (luring hypoglycemia. Diabetes 58:448-452, 2009
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available