The Relevance of Glucose Counterregulatory Systems to Patients with Insulin-Dependent Diabetes Mellitus*
Abstract
THE CENTRAL nervous system (CNS) can neither synthesize nor store glucose, its predominant metabolic fuel. Thus, it is dependent upon a continuous supply of glucose from the circulation. Hypoglycemia can cause profound dysfunction of the brain, even brain death. The fact that hypoglycemia is an uncommon clinical event, except in persons who use drugs that lower the plasma glucose concentration, is testimony to the efficacy of the physiological mechanisms that normally prevent or correct hypoglycemia. Glucoregulation is normally the result of the glucoselowering actions of insulin and the glucose-raising actions of glucose-counterregulatory factors (1, 2). It has long been recognized that deficient insulin secretion is the fundamental abnormality in patients with insulindependent diabetes mellitus (IDDM). The contribution of counterregulatory systems to glycemic excursions ranging from hypoglycemia to hyperglycemia, in the context of imperfect insulin replacement, has been documented more recently in patients with IDDM and is the subject of this review.
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Glucose counterregulatory systems are involved in the prevention, as well as the correction, of hypoglycemia in humans.
“These findings provide further support for the concept, based upon physiological and clinical evidence (1–6), that glucose counterregulatory systems are involved in the prevention, as well as the correction, of hypoglycemia in humans.”
From Glycemic thresholds for activation of glucose counterregulatory systems are higher than the threshold for symptoms. (1987) · cites this paper as [2]
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Aradhya, A. (2024) · doi:10.52768/jjgastro/1184
- Authors
- CRYER, P. E., WHITE, N. H., & SANTIAGO, J. V.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- CRYER, PHILIP E.
- ORCID
- WHITE, NEIL H.
- Venue
- Endocrine Reviews
- Publisher
- The Endocrine Society
- Published
- 1986-05
- Volume
- 7
- Issue
- 2
- Pages
- 131-139
- ISSN
- 0163-769X (ISSN-L)
- 1945-7189
- OpenAlex
- W1993679223
- Cited by
- 43
- References
- 64
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2012: 1
- FWCI
- 5.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p60am020579-08, 2r01am027085-06)
- National Center for Research Resources (RR.00036)
- 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, type 1 diabetes, hypoglycemia, hyperglycemia, insulin secretion, glucoregulation, insulin replacement therapy, glycemic excursions, counterregulatory hormones
- MeSH terms
- Adrenergic beta-Antagonists, Autonomic Nervous System Diseases, Blood Glucose, Brain, Chromaffin System, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Epinephrine, Forecasting, Glucagon, Humans, Hydrocortisone, Hyperglycemia, Hypoglycemia, Insulin, Growth Hormone, Stress, Physiological, Sympathetic Nervous System, Diabetic Ketoacidosis
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