Central mechanisms of glucose sensing and counterregulation in defense of hypoglycemia
Open accessAbstract
Glucose homeostasis requires an organism to rapidly respond to changes in plasma glucose concentrations. Iatrogenic hypoglycemia as a result of treatment with insulin or sulfonylureas is the most common cause of hypoglycemia in humans and is generally only seen in patients with diabetes who take these medications. The first response to a fall in glucose is the detection of impending hypoglycemia by hypoglycemia-detecting sensors, including glucose-sensing neurons in the hypothalamus and other regions. This detection is then linked to a series of neural and hormonal responses that serve to prevent the fall in blood glucose and restore euglycemia. In this review, we discuss the current state of knowledge about central glucose sensing and how detection of a fall in glucose leads to the stimulation of counterregulatory hormone and behavior responses. We also review how diabetes and recurrent hypoglycemia impact glucose sensing and counterregulation, leading to development of impaired awareness of hypoglycemia in diabetes.
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Multiple pathways in addition to the adrenergic system could be simultaneously involved in the pathogenesis of HAAF.
“suggesting that multiple pathways in addition to the adrenergic system could be simultaneously involved in the pathogenesis of HAAF (8, 33, 34).”
From Plasma Epinephrine Contributes to the Development of Experimental Hypoglycemia-Associated Autonomic Failure (2020) · cites this paper as [34]
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References 239 · Cited by 112
Part of this paper’s reference list could not be split into single entries.
Research works printed but not linked: 1
- Ibrahim N, Bosch MA, Smart JL, Qiu J, Rubinstein M, Rønnekleiv OK, Low MJ, Kelly MJ. Hypothalamic proopiomelanocortin neurons are glucose re- sponsive and express K ATP channels. Endocrinology. 2003;144(4):1331-1340.
- Authors
- Stanley, S., Moheet, A., & Seaquist, E. R.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- University of Minnesota (US)
- Corresponding author
- Seaquist, Elizabeth R
- Venue
- Endocrine Reviews
- Publisher
- The Endocrine Society
- Published
- 2019-01-22
- Volume
- 40
- Issue
- 3
- Pages
- 768-788
- ISSN
- 0163-769X (ISSN-L)
- 1945-7189
- PMC
- PMC6505456
- OpenAlex
- W2912229646
- Cited by
- 112
- References
- 239
- Citations by year
- 2026: 24 · 2025: 14 · 2024: 15 · 2023: 16 · 2022: 18 · 2021: 15 · 2020: 6 · 2019: 4
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Endocrine Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (NS035192)
- American Diabetes Association (#1-17-ACE-31)
- 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 › Regulation of Appetite and Obesity
- Keywords
- glucose detection, hypoglycemia, counterregulation, glucose homeostasis, counterregulatory hormones, insulin, sulfonylureas, diabetes mellitus, impaired awareness of hypoglycemia, recurrent hypoglycemia
- MeSH terms
- Animals, Blood Glucose, Glucose, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Sulfonylurea Compounds
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