PHYSIOLOGY OF GLUCOSE COUNTERREGULATION TO HYPOGLYCEMIA
Abstract
Prevention of hypoglycemia is essential for the preservation of brain metabolism and survival of the whole body. Normally, glucose is the only substrate used by the brain to meet its metabolic requirements. Therefore, a continuous supply of circulatory glucose is a necessary prerequisite for normal cerebral metabolism. When plasma glucose concentration decreases (e.g., during prolonged fasting or after administration of glucose-lowering drugs) several physiologic responses are activated to prevent further decreases in blood glucose. The first response is known as counterregulation, a system that prevents and corrects hypoglycemia through the release of counterregulatory hormones.
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In response to HPA axis activation, both liver and kidney increase endogenous glucose production, ensuring sufficient glucose supply to glucose-dependent organs, in particular the brain.
“In response to HPA axis activation, both liver and kidney increase endogenous glucose production, ensuring sufficient glucose supply to glucose-dependent organs, in particular the brain [24].”
From Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity (2010) · cites this paper as [24]
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References 96 · Cited by 99
- Authors
- Bolli, G. B., & Fanelli, C. G.
- Affiliations
- University of Perugia (IT)
- Venue
- Endocrinology and Metabolism Clinics of North America
- Publisher
- Elsevier BV
- Published
- 1999-09
- Volume
- 28
- Issue
- 3
- Pages
- 467-493
- ISSN
- 0889-8529 (ISSN-L)
- OpenAlex
- W2057289772
- Cited by
- 99
- References
- 96
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 3 · 2022: 1 · 2020: 3 · 2019: 5 · 2018: 9 · 2017: 2 · 2016: 4 · 2014: 3 · 2013: 1
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrinology and Metabolism Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- glucose counterregulation, hypoglycemia, glycemic thresholds, insulin secretion, brain glucose metabolism, diabetes mellitus, microangiopathy, macroangiopathy
- MeSH terms
- Adrenal Cortex, Animals, Blood Glucose, Brain, Disease Models, Animal, Humans, Hypoglycemia, Kidney, Liver, Pancreas, Pituitary Gland, Time Factors
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