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Metabolism

Activation of AMP-Activated Protein Kinase Within the Ventromedial Hypothalamus Amplifies Counterregulatory Hormone Responses in Rats With Defective Counterregulation

  1. Rory J. McCrimmon,
  2. Xiaoning Fan,
  3. Haiying Cheng,
  4. Ewan McNay,
  5. Owen Chan,
  6. Margaret Shaw,
  7. Yuyan Ding,
  8. Wanling Zhu and
  9. Robert S. Sherwin
  1. Department of Internal Medicine and Endocrinology, Yale University School of Medicine, New Haven, Connecticut
  1. Address correspondence and reprint requests to Rory J. McCrimmon, MD, FRCP, Yale University School of Medicine, P.O. Box 208020, New Haven, CT 06520-8020. E-mail: rory.mccrimmon{at}yale.edu
Diabetes 2006 Jun; 55(6): 1755-1760. https://doi.org/10.2337/db05-1359
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Abstract

Defective counterregulatory responses (CRRs) to hypoglycemia are associated with a marked increase in the risk of severe hypoglycemia. The mechanisms leading to the development of defective CRRs remain largely unknown, although they are associated with antecedent hypoglycemia. Activation of AMP-activated protein kinase (AMPK) in the ventromedial hypothalamus (VMH) amplifies the counterregulatory increase in glucose production during acute hypoglycemia. To examine whether activation of AMPK in the VMH restores defective CRR, controlled hypoglycemia (∼2.8 mmol/l) was induced in a group of 24 Sprague-Dawley rats, all of which had undergone a 3-day model of recurrent hypoglycemia before the clamp study. Before the acute study, rats were microinjected to the VMH with either 5-aminoimidazole-4-carboxamide (AICAR; n = 12), to activate AMPK, or saline (n = 12). In a subset of rats, an infusion of H3-glucose was additionally started to calculate glucose turnover. Stimulation of AMPK within the VMH was found to amplify hormonal CRR and increase endogenous glucose production. In addition, analysis of tissue from both whole hypothalamus and VMH showed that recurrent hypoglycemia induces an increase in the gene expression of AMPK α1 and α2. These findings suggest that the development of novel drugs designed to selectively activate AMPK in the VMH offer a future therapeutic potential for individuals with type 1 diabetes who have defective CRRs to hypoglycemia.

  • AICAR, 5-aminoimidazole-4-carboxamide
  • AMPK, AMP-activated protein kinase
  • CRR, counterregulatory reponse
  • VMH, ventromedial hypothalamus

Footnotes

  • DOI: 10.2337/db05-1359

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted March 13, 2006.
    • Received October 18, 2005.
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Activation of AMP-Activated Protein Kinase Within the Ventromedial Hypothalamus Amplifies Counterregulatory Hormone Responses in Rats With Defective Counterregulation
Rory J. McCrimmon, Xiaoning Fan, Haiying Cheng, Ewan McNay, Owen Chan, Margaret Shaw, Yuyan Ding, Wanling Zhu, Robert S. Sherwin
Diabetes Jun 2006, 55 (6) 1755-1760; DOI: 10.2337/db05-1359

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Activation of AMP-Activated Protein Kinase Within the Ventromedial Hypothalamus Amplifies Counterregulatory Hormone Responses in Rats With Defective Counterregulation
Rory J. McCrimmon, Xiaoning Fan, Haiying Cheng, Ewan McNay, Owen Chan, Margaret Shaw, Yuyan Ding, Wanling Zhu, Robert S. Sherwin
Diabetes Jun 2006, 55 (6) 1755-1760; DOI: 10.2337/db05-1359
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