Recurrent hypoglycemia: boosting the brain's metabolic flexibility

M Litvin, AL Clark, SJ Fisher - The Journal of Clinical …, 2013 - Am Soc Clin Investig
M Litvin, AL Clark, SJ Fisher
The Journal of Clinical Investigation, 2013Am Soc Clin Investig
For people with diabetes, recurrent episodes of hypoglycemia limit the brain's ability to
sense dangerously low blood sugar levels. In this issue of the JCI, the mechanisms behind
this clinical problem of hypoglycemia unawareness are addressed by Herzog et al. The
authors provide compelling evidence that recurrent hypoglycemia enhances transport of
lactate into the brain and, although not itself a major alternative fuel source, lactate may
preserve neuronal function during hypoglycemia by maintaining neuronal glucose …
For people with diabetes, recurrent episodes of hypoglycemia limit the brain’s ability to sense dangerously low blood sugar levels. In this issue of the JCI, the mechanisms behind this clinical problem of hypoglycemia unawareness are addressed by Herzog et al. The authors provide compelling evidence that recurrent hypoglycemia enhances transport of lactate into the brain and, although not itself a major alternative fuel source, lactate may preserve neuronal function during hypoglycemia by maintaining neuronal glucose metabolism. These findings redefine our understanding of the brain’s metabolic adaptations that result from recurrent hypoglycemia.
The Journal of Clinical Investigation
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