Neuroendocrine responses to hypoglycemia

Tesfaye, Nolawit; Seaquist, Elizabeth R.

doi:10.1111/j.1749-6632.2010.05820.x

Cited by 164Diabetes Management and ResearchPancreatic function and diabetesNeuroscience of respiration and sleep

Neuroendocrine responses to hypoglycemia

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Tesfaye, Nolawit, Seaquist, Elizabeth R.·2010·Annals of the New York Academy of Sciences

DOI 10.1111/j.1749-6632.2010.05820.xPMC PMC2991551

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Abstract

The counterregulatory response to hypoglycemia is a complex and well-coordinated process. As blood glucose concentration declines, peripheral and central glucose sensors relay this information to central integrative centers to coordinate neuroendocrine, autonomic, and behavioral responses and avert the progression of hypoglycemia. Diabetes, both type 1 and type 2, can perturb these counterregulatory responses. Moreover, defective counterregulation in the setting of diabetes can progress to hypoglycemia unawareness. While the mechanisms that underlie the development of hypoglycemia unawareness are not completely known, possible causes include altered sensing of hypoglycemia by the brain and/or impaired coordination of responses to hypoglycemia. Further study is needed to better understand the intricacies of the counterregulatory response and the mechanisms contributing to the development of hypoglycemia unawareness.

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Cortisol has a key role in glucose homeostasis, particularly in the counter-regulatory mechanisms to prevent hypoglycaemia in times of biological stress.
“Cortisol has a key role in glucose homeostasis, particularly in the counter-regulatory mechanisms to prevent hypoglycaemia in times of biological stress.”
From Hypoglycaemia in adrenal insufficiency (2023) · cites this paper as [13]
In “The counterregulatory factors” (page not provided), the paper says cortisol helps limit the degree of prolonged hypoglycemia through metabolic effects. It also says cortisol has no immediate role in recovery from acute hypoglycemia. The claim’s broader emphasis on preventing hypoglycemia during biological stress is not established by these passages. (LLM, conf=0.86)
Experimental — accuracy not yet measured
After antecedent hypoglycemia, GH responses were significantly suppressed.
“After antecedent hypoglycemia, GH responses were significantly suppressed [ 22 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [22]
GH induces glucose level changes over several hours by stimulating lipolysis in adipose tissue as well as ketogenesis and gluconeogenesis in the liver.
“GH induces glucose level changes over several hours by stimulating lipolysis in adipose tissue as well as ketogenesis and gluconeogenesis in the liver [ 22 , 27 , 28 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [22]

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Oral Glucose Augments the Counterregulatory Hormone Response during Insulin-Induced Hypoglycemia in Humans1
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Post-hypoglycaemic hyperketonaemia does not contribute to brain metabolism during insulin-induced hypoglycaemia in humans
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Hypoglycemic Detection at the Portal Vein
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Combined corticotropin-releasing hormone and glucocorticoid deficiency does not enhance counterregulatory responses after recurrent hypoglycemia in mice
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Patients with type 2 diabetes treated with sulphonylureas develop symptoms of hypoglycaemia but not adrenergic or cognitive responses, at higher glucose levels than insulin treated patients
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[57]Donovan CM Bohland MA Hypoglycemic detection at the portal vein absent in humans or yet to be elucidated? Diabetes 2009 58 21 23 19114726 PMC2606875
[83]Bolli G Tsalikian E Haymond M Cryer P Gerich J Defective glucose counterregulation after subcutaneous insulin in non-insulin dependent diabetes mellitus J. Clin. Invest 1984 73 1532 1541 6373827 PMC437063

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Authors: Tesfaye, N., & Seaquist, E. R.
Affiliations: University of Minnesota (US)
Corresponding author: Seaquist, Elizabeth R.
ORCID: Seaquist, Elizabeth R.
Venue: Annals of the New York Academy of Sciences
Publisher: Wiley
Published: 2010-10-29
Volume: 1212
Issue: 1
Pages: 12-28
ISSN: 0077-8923 (ISSN-L)
1749-6632
DOI: 10.1111/j.1749-6632.2010.05820.x
PMC: PMC2991551
OpenAlex: W1800997121
Cited by: 164
References: 140
Citations by year: 2026: 7 · 2025: 15 · 2024: 8 · 2023: 13 · 2022: 10 · 2021: 24 · 2020: 26 · 2019: 10 · 2018: 7 · 2017: 12 · 2016: 4 · 2015: 6 · 2014: 4 · 2013: 7 · 2012: 4
FWCI: 0.82
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Annals of the New York Academy of Sciences (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (2 T32 DK7203-33, T32DK007203)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords: hypoglycemia, counterregulatory response, neuroendocrine response, autonomic responses, glucose detection, hypoglycemia unawareness, type 1 diabetes, type 2 diabetes, blood glucose regulation
MeSH terms: Animals, Blood Glucose, Central Nervous System, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Hypoglycemia, Models, Biological, Neurosecretory Systems, Feedback, Physiological

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Neuroendocrine responses to hypoglycemia

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