Brain glucose metabolism during hypoglycemia in type 1 diabetes: insights from functional and metabolic neuroimaging studies.
Brain glucose metabolism during hypoglycemia in type 1 diabetes: insights from functional and metabolic neuroimaging studies.
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DOI：
10.1007/s00018-015-2079-8
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
de Galan BE
中科院分区：
文献类型：
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作者：
Rooijackers HM;Wiegers EC;Tack CJ;van der Graaf M;de Galan BE
低血糖是1型糖尿病患者胰岛素治疗最常见的并发症。由于大脑依赖于循环葡萄糖作为其主要能量来源，低血糖症对正常的大脑功能构成威胁。奇怪的是，虽然低血糖通常会引起认知功能的立即下降，但在1型糖尿病患者中，脑结构和认知功能的长期变化并不常见。事实上，复发性低血糖会引发一个习惯化过程，抑制对后续低血糖的激素反应并损害对后续低血糖的意识，这归因于大脑中的适应。这些观察结果引发了人们对大脑在（复发性）低血糖期间处理葡萄糖的极大科学兴趣。各种神经成像技术已被用于研究大脑（葡萄糖）代谢，包括PET，fMRI，MRS和ASL。这篇综述讨论了目前所知的低血糖期间的脑代谢，以及如何通过功能和代谢神经影像学技术获得的结果有助于这方面的知识。
Hypoglycemia is the most frequent complication of insulin therapy in patients with type 1 diabetes. Since the brain is reliant on circulating glucose as its main source of energy, hypoglycemia poses a threat for normal brain function. Paradoxically, although hypoglycemia commonly induces immediate decline in cognitive function, long-lasting changes in brain structure and cognitive function are uncommon in patients with type 1 diabetes. In fact, recurrent hypoglycemia initiates a process of habituation that suppresses hormonal responses to and impairs awareness of subsequent hypoglycemia, which has been attributed to adaptations in the brain. These observations sparked great scientific interest into the brain’s handling of glucose during (recurrent) hypoglycemia. Various neuroimaging techniques have been employed to study brain (glucose) metabolism, including PET, fMRI, MRS and ASL. This review discusses what is currently known about cerebral metabolism during hypoglycemia, and how findings obtained by functional and metabolic neuroimaging techniques contributed to this knowledge.