Document Detail


The physiology and pathophysiology of the neural control of the counterregulatory response.
MedLine Citation:
PMID:  22071156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite significant technological and pharmacological advancements, insulin replacement therapy fails to adequately replicate β-cell function, and so glucose control in type 1 diabetes mellitus (T1D) is frequently erratic, leading to periods of hypoglycemia. Moreover, the counterregulatory response (CRR) to falling blood glucose is impaired in diabetes, leading to an increased risk of severe hypoglycemia. It is now clear that the brain plays a significant role in the development of defective glucose counterregulation and impaired hypoglycemia awareness in diabetes. In this review, the basic intracellular glucose-sensing mechanisms are discussed, as well as the neural networks that respond to and coordinate the body's response to a hypoglycemic challenge. Subsequently, we discuss how the body responds to repeated hypoglycemia and how these adaptations may explain, at least in part, the development of impaired glucose counterregulation in diabetes.
Authors:
Craig Beall; Michael L Ashford; Rory J McCrimmon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2011-11-09
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  302     ISSN:  1522-1490     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-04     Completed Date:  2012-02-17     Revised Date:  2012-05-23    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  R215-23     Citation Subset:  IM    
Affiliation:
Medical Research Institute, Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital and Medical School, Univ. of Dundee, Dundee, DD1 9SY, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / physiology*
Blood Glucose / physiology*
Brain / physiopathology*
Diabetes Mellitus / drug therapy,  physiopathology*
Humans
Hypoglycemia / physiopathology*
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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