Reversibility of brain glucose kinetics in type 2 diabetic subjects

项目概要/摘要 2型糖尿病的患病率在全球范围内持续上升，尽管治疗方法不同， 然而，许多患者未能达到血糖目标，这导致发病率和死亡率增加。 在动物和人体研究中，长期暴露于高血糖状态可降低血糖水平 转运到大脑，可能是通过下调血脑屏障上的GLUT 1， 被认为是中枢神经系统对有害后果的保护性适应 高血糖症然而，GLUT 1下调可能导致脑葡萄糖代谢减少，从而导致 神经元损伤、神经变性和认知能力下降。这些脑葡萄糖的变化 在控制不佳的糖尿病患者中观察到的转运可以逆转是未知的。这个的主要目标 研究旨在确定血糖控制不佳的T2 DM患者血糖控制改善是否会恢复 脑葡萄糖转运动力学，并严格评估哪些因素（即DM持续时间和血糖控制） 通过使用经典的代谢研究以及最先进的大脑， 核磁共振波谱（MRS）技术。这项研究的结果将有助于 阐明强化糖尿病治疗是否可能与降低高血糖引起的脑功能障碍有关。

Project summary/abstract The prevalence of type 2 diabetes mellitus continues to rise worldwide and despite different treatment options, many patients fail to achieve glycemic target, which leads to increased morbidity and mortality. Chronic exposure to hyperglycemia has been shown in both animal and human studies to decrease glucose transport into the brain, presumably through down-regulation of GLUT1 at the blood brain barrier, which has been postulated to be a protective adaptation of the central nervous system against the harmful consequences of hyperglycemia. However, GLUT1 down regulation may lead to reduced brain glucose metabolism leading to neuronal damage, neurodegeneration and cognitive decline. Whether these changes in cerebral glucose transport seen in patients with poorly controlled diabetes can be reversed is unknown. The main goal of this study is to determine whether improvement of glucose control in poorly controlled T2DM patient will restore brain glucose transport kinetics and rigorously assess which factors (i.e. duration DM and glycemic control) contribute to the observed improvements by using classic metabolic studies as well as state-of-the-art brain nuclear magnetic resonance spectroscopy (MRS) techniques. The findings obtained from this study will help elucidate if intensive diabetes therapy may be associated with reduced brain dysfunction from hyperglycemia.