HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Cherrington, A. D. PubMed PubMed Citation Articles by Cherrington, A. D. Related Collections Related Article Social Bookmarking                What's this?

Central Versus Peripheral Glucose Sensing and the Response to Hypoglycemia

From the Department of Molecular Physiology and Biophysics, Vanderbilt University Medical School, Nashville, Tennessee

Corresponding author: Vanderbilt University Medical School, Department of Molecular Physiology and Biophysics, 704 Robinson Research Building, Nashville, TN 37232-0615. E-mail: alan.cherrington@vanderbilt.edu

The first 20% of the full text of this article appears below.

One of the most significant limits in our ability to tightly control blood glucose in patients with diabetes is the occurrence of hypoglycemia. It is now clear that when blood glucose drops in a normal individual, there is a rapid and well-coordinated endocrine response (1). Glucagon, epinephrine, norepinephrine, cortisol, and growth hormone levels rise as the glucose level falls (1). The combination of low blood glucose and elevated hormones limits glucose utilization by the tissues of the body and stimulates glucose production by the liver (2). As a consequence of these metabolic adjustments, the fall in blood glucose is limited and the ensuing hypoglycemia is minimized. In an individual with diabetes, the glucagon response to hypoglycemia begins to diminish relatively early in the disease process (1). Later, even the sympatho-adrenal response may become limited (1). As a consequence, individuals with diabetes, particularly type 1 diabetes, are at increased risk for serious hypoglycemia. Understanding more about the normal response to hypoglycemia and about the failure of the normal response in diabetic individuals is thus of great importance.

A recent debate in this area relates to the site of hypoglycemic sensing. While it has long been known that the brain is involved in detecting low blood glucose, data began to appear in the early 1990s supporting the view that hypoglycemic sensing was also occurring at peripheral sites, particularly within the hepato-portal region. A series of articles . . . [Full Text of this Article]

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Article:

The Locus for Hypoglycemic Detection Shifts With the Rate of Fall in Glycemia: The Role of Portal–Superior Mesenteric Vein Glucose Sensing

Maziyar Saberi, MaryAnn Bohland, and Casey M. Donovan
Diabetes 2008 57: 1380-1386. [Abstract] [Full Text] [PDF]