Neuroendocrine responses to hypoglycemia

Ann N Y Acad Sci. 2010 Nov;1212:12-28. doi: 10.1111/j.1749-6632.2010.05820.x. Epub 2010 Oct 29.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Blood Glucose / metabolism
  • Central Nervous System / metabolism
  • Central Nervous System / physiopathology
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology
  • Feedback, Physiological / physiology
  • Humans
  • Hypoglycemia / complications
  • Hypoglycemia / diagnosis
  • Hypoglycemia / physiopathology*
  • Models, Biological
  • Neurosecretory Systems / metabolism
  • Neurosecretory Systems / physiopathology*

Substances

  • Blood Glucose