The robust neuroendocrine counterregulatory responses induced by hypoglycemia protect the brain by restoring plasma glucose, but little is known about molecular responses to hypoglycemia that may also be neuroprotective. To clarify these mechanisms, we examined gene expression in hypothalamus, cortex, and liver 3 h after induction of mild hypoglycemia by a single injection of insulin, using cDNA microarray analysis and quantitative real-time PCR. Real-time PCR corroborated the induction of six genes (angiotensinogen, GLUT-1, inhibitor of kappaB, inhibitor of DNA binding 1 [ID-1], Ubp41, and mitogen-activated protein kinase phosphatase-1 [MKP-1]) by insulin-induced hypoglycemia in the hypothalamus: five of these six genes in cortex and three (GLUT-1, angiotensinogen, and MKP-1) in liver. The induction was due to hypoglycemia and not hyperinsulinemia, since fasting (characterized by low insulin and glucose) also induced these genes. Four of these genes (angiotensinogen, GLUT-1, ID-1, and MKP-1) have been implicated in enhancement of glucose availability, which could plausibly serve a neuroprotective role during acute hypoglycemia but, if persistent, could also cause glucose-sensing mechanisms to overestimate plasma glucose levels, potentially causing hypoglycemia-induced counterregulatory failure. Although using cDNA microarrays with more genes, or microdissection, would presumably reveal further responses to hypoglycemia, these hypoglycemia-induced genes represent useful markers to assess molecular mechanisms mediating cellular responses to hypoglycemia.
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http://dx.doi.org/10.2337/diabetes.54.4.952 | DOI Listing |
Diabet Med
January 2025
Department of Internal Medicine, University of Kentucky, Lexington, USA.
Aim: Several wordings of the definition of severe hypoglycaemia (SH) exist. This study aims to evaluate how different SH definition wordings affect SH history assessment.
Methods: In this cross-sectional study, surveys were emailed to registrants of the T1D Exchange, a U.
Nutrients
December 2024
Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy.
Background: A neuroinflammatory disease such as Alzheimer's disease, presents a significant challenge in neurotherapeutics, particularly due to the complex etiology and allostatic factors, referred to as CNS stressors, that accelerate the development and progression of the disease. These CNS stressors include cerebral hypo-glucose metabolism, hyperinsulinemia, mitochondrial dysfunction, oxidative stress, impairment of neuronal autophagy, hypoxic insults and neuroinflammation. This study aims to explore the efficacy and safety of DAG-MAG-ΒHB, a novel ketone diester, in mitigating these risk factors by sustaining therapeutic ketosis, independent of conventional metabolic pathways.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
January 2025
Harvard Medical School, Boston, MA, USA.
Background: Our goal was to determine in healthy individuals and individuals with type 2 diabetes the impact of repeated episodes of hypoglycemia on the corrected QT (QTc) interval and the time course for QTc recovery. Further, since hypoglycemia increases aldosterone and patients with primary aldosteronism have prolonged QTc, we also determined whether mineralocorticoid receptor blockade prevents hypoglycemia-induced QTc alterations.
Methods: Twenty-seven healthy participants completed a double-blinded crossover trial contrasting 3 experimental conditions: 1) euglycemia, 2) hypoglycemia, and 3) hypoglycemia with mineralocorticoid receptor blockade pretreatment.
Anesth Analg
November 2024
Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, California.
Background: Several international pediatric anesthesia societies have endorsed a change in the traditional nil per os (NPO) cutoff of clear fluids (CF) from 2 hours to 1 hour. These recommendations were compiled from large-scale outcomes, gastric ultrasound, and quality improvement studies. The American Society of Anesthesiologists (ASA) recently published their updated guidelines.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Division of General Surgery, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.
: Religious fasting in patients after Metabolic and Bariatric Surgery (MBS) remains a topic with limited clarity. This study aims to present the results of a survey on religious fasting in patients after MBS in Israel. The questionnaire was sent to members of the Israeli Society for Metabolic and Bariatric Surgery (ISMBS).
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