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Impact of Hypoglycemia on Brain Metabolism During Diabetes

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Abstract

Diabetes is a metabolic disease afflicting millions of people worldwide. A substantial fraction of world’s total healthcare expenditure is spent on treating diabetes. Hypoglycemia is a serious consequence of anti-diabetic drug therapy, because it induces metabolic alterations in the brain. Metabolic alterations are one of the central mechanisms mediating hypoglycemia-related functional changes in the brain. Acute, chronic, and/or recurrent hypoglycemia modulate multiple metabolic pathways, and exposure to hypoglycemia increases consumption of alternate respiratory substrates such as ketone bodies, glycogen, and monocarboxylates in the brain. The aim of this review is to discuss hypoglycemia-induced metabolic alterations in the brain in glucose counterregulation, uptake, utilization and metabolism, cellular respiration, amino acid and lipid metabolism, and the significance of other sources of energy. The present review summarizes information on hypoglycemia-induced metabolic changes in the brain of diabetic and non-diabetic subjects and the manner in which they may affect brain function.

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Acknowledgements

This study was supported by National Institutes of Health grant NS073779. We would like to thank Dr. Brant Watson for critical reading of this manuscript.

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  1. Cerebral Vascular Disease Research Laboratories, University of Miami Miller School of Medicine, Miami, FL, 33136, USA

    Ashish K. Rehni & Kunjan R. Dave

  2. Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Ave, NRB/203E, Miami, FL, 33136, USA

    Ashish K. Rehni & Kunjan R. Dave

  3. Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, 33136, USA

    Kunjan R. Dave

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  1. Ashish K. Rehni
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Rehni, A.K., Dave, K.R. Impact of Hypoglycemia on Brain Metabolism During Diabetes. Mol Neurobiol 55, 9075–9088 (2018). https://doi.org/10.1007/s12035-018-1044-6

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