Document Detail

Patients with type 1 diabetes exhibit altered cerebral metabolism during hypoglycemia.
MedLine Citation:
PMID:  23298837     Owner:  NLM     Status:  MEDLINE    
Patients with type 1 diabetes mellitus (T1DM) experience, on average, 2 to 3 hypoglycemic episodes per week. This study investigated the effect of hypoglycemia on cerebral glucose metabolism in patients with uncomplicated T1DM. For this purpose, hyperinsulinemic euglycemic and hypoglycemic glucose clamps were performed on separate days, using [1-13C]glucose infusion to increase plasma 13C enrichment. In vivo brain 13C magnetic resonance spectroscopy was used to measure the time course of 13C label incorporation into different metabolites and to calculate the tricarboxylic acid cycle flux (VTCA) by a one-compartment metabolic model. We found that cerebral glucose metabolism, as reflected by the VTCA, was not significantly different comparing euglycemic and hypoglycemic conditions in patients with T1DM. However, the VTCA was inversely related to the HbA1C and was, under hypoglycemic conditions, approximately 45% higher than that in a previously investigated group of healthy subjects. These data suggest that the brains of patients with T1DM are better able to endure moderate hypoglycemia than those of subjects without diabetes.
Kim C C van de Ven; Cees J Tack; Arend Heerschap; Marinette van der Graaf; Bastiaan E de Galan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-09
Journal Detail:
Title:  The Journal of clinical investigation     Volume:  123     ISSN:  1558-8238     ISO Abbreviation:  J. Clin. Invest.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-04-19     Completed Date:  2013-05-13     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  7802877     Medline TA:  J Clin Invest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  623-9     Citation Subset:  AIM; IM    
Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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MeSH Terms
Blood Glucose / metabolism
Brain / metabolism*
Carbon Isotopes
Citric Acid Cycle
Diabetes Mellitus, Type 1 / blood,  metabolism*
Glucose Clamp Technique
Glutamic Acid / metabolism
Hemoglobin A, Glycosylated / metabolism
Hypoglycemia / blood,  metabolism*
Magnetic Resonance Spectroscopy
Models, Biological
Young Adult
Reg. No./Substance:
0/Blood Glucose; 0/Carbon Isotopes; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human; 56-86-0/Glutamic Acid

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