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- Title
Human Type 1 Diabetes Is Characterized by an Early, Marked, Sustained, and Islet-Selective Loss of Sympathetic Nerves.
- Authors
Mundinger, Thomas O.; Qi Mei; Foulis, Alan K.; Fligner, Corinne L.; Hull, Rebecca L.; Taborsky Jr., Gerald J.; Mei, Qi; Taborsky, Gerald J Jr
- Abstract
In humans, the glucagon response to moderate-to-marked insulin-induced hypoglycemia (IIH) is largely mediated by the autonomic nervous system. Because this glucagon response is impaired early in type 1 diabetes, we sought to determine if these patients, like animal models of autoimmune diabetes, have an early and severe loss of islet sympathetic nerves. We also tested whether this nerve loss is a permanent feature of type 1 diabetes, is islet-selective, and is not seen in type 2 diabetes. To do so, we quantified pancreatic islet and exocrine sympathetic nerve fiber area from autopsy samples of patients with type 1 or 2 diabetes and control subjects without diabetes. Our central finding is that patients with either very recent onset (<2 weeks) or long duration (>10 years) of type 1 diabetes have a severe loss of islet sympathetic nerves (Δ = -88% and Δ = -79%, respectively). In contrast, patients with type 2 diabetes lose no islet sympathetic nerves. There is no loss of exocrine sympathetic nerves in either type 1 or type 2 diabetes. We conclude that patients with type 1, but not type 2, diabetes have an early, marked, sustained, and islet-selective loss of sympathetic nerves, one that may impair their glucagon response to IIH.
- Subjects
GLUCAGON; INSULIN; HYPOGLYCEMIA; AUTONOMIC nervous system; TYPE 1 diabetes; IMMUNOHISTOCHEMISTRY; ISLANDS of Langerhans; TYPE 2 diabetes; PANCREAS; RESEARCH funding; SYMPATHETIC nervous system
- Publication
Diabetes, 2016, Vol 65, Issue 8, p2322
- ISSN
0012-1797
- Publication type
journal article
- DOI
10.2337/db16-0284