Reversibility of brain glucose kinetics in type 2 diabetic subjects

项目摘要/摘要 尽管采取了不同的治疗方法，但2型糖尿病的患病率在全球范围内继续上升 许多患者无法达到血糖控制目标，从而导致发病率和死亡率增加。 动物和人类的研究都表明，长期暴露在高血糖环境中可以降低血糖 转运到大脑，可能是通过下调血脑屏障上的GLUT1，这有 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，GLUT1下调可能会导致大脑葡萄糖代谢降低，从而导致 神经元损伤、神经退行性变和认知功能衰退。这些脑部血糖的变化 糖尿病控制不佳的患者体内的转运是否可以逆转尚不清楚。这样做的主要目标是 一项研究旨在确定控制不良的T2 DM患者的血糖控制改善是否会恢复 大脑葡萄糖转运动力学，并严格评估哪些因素(即持续时间、糖尿病和血糖控制) 通过使用经典的新陈代谢研究和最先进的大脑，为观察到的改善做出贡献 核磁共振波谱(MRS)技术。从这项研究中获得的发现将会有所帮助。 阐明强化糖尿病治疗是否与减少高血糖所致的脑功能障碍有关。

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.