Cited by 63Diabetes Management and ResearchPancreatic function and diabetesNeuroscience of respiration and sleep

The physiology and pathophysiology of the neural control of the counterregulatory response

Beall, Craig, Ashford, Michael L., McCrimmon, Rory J.·2012·American Journal of Physiology-Regulatory, Integrative and Comparative Physiology

Abstract

Despite significant technological and pharmacological advancements, insulin replacement therapy fails to adequately replicate β-cell function, and so glucose control in type 1 diabetes mellitus (T1D) is frequently erratic, leading to periods of hypoglycemia. Moreover, the counterregulatory response (CRR) to falling blood glucose is impaired in diabetes, leading to an increased risk of severe hypoglycemia. It is now clear that the brain plays a significant role in the development of defective glucose counterregulation and impaired hypoglycemia awareness in diabetes. In this review, the basic intracellular glucose-sensing mechanisms are discussed, as well as the neural networks that respond to and coordinate the body's response to a hypoglycemic challenge. Subsequently, we discuss how the body responds to repeated hypoglycemia and how these adaptations may explain, at least in part, the development of impaired glucose counterregulation in diabetes.

Integrity signals

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Crossref · 10.1152/ajpregu.00531.2011

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122 of 122 references verified0 citation errors · 0 not checkable

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  • The central nervous system modulates glucagon secretion, increasing the complexity and difficulties of identifying a transport model.

    “In addition, the central nervous system also modulates glucagon secretion,24,25 which increases the complexity and difficulties of identifying a transport model.”

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Authors
Beall, C., Ashford, M. L., & McCrimmon, R. J.
Affiliations
University of Dundee (GB)
Corresponding author
McCrimmon, Rory J.
Venue
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology
Published
2012-01-15
Volume
302
Issue
2
Pages
R215-R223
ISSN
  • 0363-6119 (ISSN-L)
  • 1522-1490
OpenAlex
W2103461975
Cited by
63
References
122
Citations by year
2026: 3 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 8 · 2016: 7 · 2015: 4 · 2014: 2 · 2013: 11
FWCI
0.58
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Physiology-Regulatory, Integrative and Comparative Physiology (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
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
counterregulatory response, type 1 diabetes, hypoglycemia, hypoglycemia awareness, glucose detection, artificial neural networks, insulin replacement therapy, beta-cell function
MeSH terms
Adaptation, Physiological, Blood Glucose, Brain, Diabetes Mellitus, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin

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