Hypoglycemia, Gluconeogenesis and the Brain

  • A. D. Cherrington
  • R. T. Frizzell
  • D. W. Biggers
  • C. C. Connolly
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 291)


The purpose of this chapter is to review the role which gluconeo- genesis plays in the response to insulin-induced hypoglycemia and to assess the influence of the brain in driving that response. The chapter is divided into three parts: the response of gluconeogenesis to hypoglycemia; the role of the brain in driving hormone secretion, and as a result gluconeogenesis, during hypoglycemia; and the role of the brain in stimulating gluconeogenesis directly during glucodeprivation.


Vertebral Artery Glucose Production Insulin Infusion Counterregulatory Hormone Autoregulatory Response 


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  1. 1.
    Garber, A.J., Cryer, P.E., Santiago, J.V., Haymond, M.W., Pagliara, A.S. and Kipnis, D.M. The role of adrenergic mechanisms in the substrate and hormonal response to insulin-induced hypoglycemia in man. J. Clin. Invest. 8: 7–15, 1976.CrossRefGoogle Scholar
  2. 2.
    Clark, W.L., Santiago, J.V., Thomas, L., Ben-Galim, E., Haymond, M.W., and Cryer, P.E.: Adrenergic mechanisms in recovery from hyopoglycemia in man: Adrenergic blockade. Am. J. Physiol. 236(2): E147–E152, 1979.Google Scholar
  3. 3.
    Gauthier C., and Hetenyi, G., Jr.: Origin of glucose released in the regulatory response against hypoglycemia. Metabolism 31: 147–153, 1982.PubMedCrossRefGoogle Scholar
  4. 4.
    Frizzell, R.T., Hendrick, G.K., Biggers, D.W., Lacy, D.B., Donahue, D.P., Green, D.R., Carr, R.K., Williams, P.E., Stevenson, R.W. and Cherrington, A.D.: The role of gluconeogenesis in sustaining glucose production during hypoglycemia in response to insulin infusion in the conscious dog. Diabetes 37: 749–759, 1988.PubMedCrossRefGoogle Scholar
  5. 5.
    LeCavalier, L., Bolli, G., and Gerich, J.: Major role for gluconeogenesis during counterregulation in man. Diabetes (Suppl. 1) 1987.Google Scholar
  6. 6.
    Rizza, R., Cryer, P. and Gerich, J.: Role of glucagon, catecholamines, and growth hormone in human glucose counterregulation: effects of somatostatin and combined ’-and adrenergic blockade on plasma glucose recovery and glucose flux rates after insulin-induced hypoglycemia. J. Clin. Invest. 64: 62–71. 1979.PubMedCrossRefGoogle Scholar
  7. 7.
    Gerich, J., Davis, J., Lorenz, M., Rizza, R., Karam, J., Lewis, S., Daplan, R., Schultz, T. and Cryer, P.: Hormone mechanisms of recovery from insullin-induced hypoglycemia in man. Am. J. Physiol. 236:380–385, 1979.Google Scholar
  8. 8.
    Cryer,: Glucose counterregulation in man. Diabetes, 30: 261–164, 1981.PubMedGoogle Scholar
  9. 9.
    Ivy, R., Adkins, B., Williams, P., Neal, D., Cherrington, A.D. The role of epinephrine in counterregulation in hypoglycemia induced by insulin infusion. Diabetes 36: 25A, 1987.Google Scholar
  10. 10.
    Dobbins, R.L., Connolly, C.C., Neal, D.W., Palladino, L.S., Parlow, A.F. and Cherrington, A.D.: The role of glucagon in countering the hypoglycemia induced by insulin infusion. Diabetes (submitted).Google Scholar
  11. 11.
    Frizzell, R.T., Hendrick, G.K., Biggers, D.W., Lacy, D.B., Donahue, D.P. Green, D.R., Carr, R.K., Williams, P.W., Stevenson, R.W., and Cherrington, A.D.: Hypoglycemia induced by insulin infusion stimulates glucose production through mechanisms in addition to hormone secretion. Diabetes (in press).Google Scholar
  12. 12.
    Biggers, D.W., Myers, S.R., Neal, D., Stinson, R., Cooper, N.B., Jaspan, J.B., Williams, P.E., Cherrington, A.D., and Frizzell, R.T. Role of brain in counterregulation of insulin-induced hypoglycemia in dogs. Diabetes 38: 7–16, 1989.PubMedCrossRefGoogle Scholar
  13. 13.
    McGraw, E.F., Peterson, M.J. and Ashmore, J. Autoregulation of glucose metabolism in the isolated perfused rat liver. Proc. Soc. Exp. Biol. Med. 126: 232–236, 1967.Google Scholar
  14. 14.
    Glinsmann, W.H., Hern, E.P. and Lynch, A. Intrinsic regulation of glucose output by rat liver. Am. J. Physiol. 216: 698–703, 1969.PubMedGoogle Scholar
  15. 15.
    Frizzell, R.T., Campbell, P., and Cherrington, A.D. Gluconeogenesis and hypoglycemia. In: Diabetes/Metabolism Reviews. R. DeFronzo (Ed.), John Wiley and Sons, Inc., New York, Vol. 4, pp. 51–70, 1988.Google Scholar

Copyright information

© Plenum Press, New York 1991

Authors and Affiliations

  • A. D. Cherrington
    • 1
  • R. T. Frizzell
    • 1
  • D. W. Biggers
    • 1
  • C. C. Connolly
    • 1
  1. 1.Department of Molecular Physiology and BiophysicsVanderbilt University Medical SchoolNashvilleUSA

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