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- Title
Glycemic Variability and Brain Glucose Levels in Type 1 Diabetes.
- Authors
Hwang, Janice J.; Lihong Jiang; Rangel, Elizabeth Sanchez; Xiaoning Fan; Yuyan Ding; Wai Lam; Leventhal, Jessica; Feng Dai; Rothman, Douglas L.; Mason, Graeme F.; Sherwin, Robert S.; Jiang, Lihong; Fan, Xiaoning; Ding, Yuyan; Lam, Wai; Dai, Feng; Sanchez Rangel, Elizabeth
- Abstract
The impact of glycemic variability on brain glucose transport kinetics among individuals with type 1 diabetes mellitus (T1DM) remains unclear. Fourteen individuals with T1DM (age 35 ± 4 years; BMI 26.0 ± 1.4 kg/m2; HbA1c 7.6 ± 0.3) and nine healthy control participants (age 32 ± 4; BMI 23.1 ± 0.8; HbA1c 5.0 ± 0.1) wore a continuous glucose monitor (Dexcom) to measure hypoglycemia, hyperglycemia, and glycemic variability for 5 days followed by 1H MRS scanning in the occipital lobe to measure the change in intracerebral glucose levels during a 2-h glucose clamp (target glucose concentration 220 mg/dL). Hyperglycemic clamps were also performed in a rat model of T1DM to assess regional differences in brain glucose transport and metabolism. Despite a similar change in plasma glucose levels during the hyperglycemic clamp, individuals with T1DM had significantly smaller increments in intracerebral glucose levels (P = 0.0002). Moreover, among individuals with T1DM, the change in brain glucose correlated positively with the lability index (r = 0.67, P = 0.006). Consistent with findings in humans, streptozotocin-treated rats had lower brain glucose levels in the cortex, hippocampus, and striatum compared with control rats. These findings that glycemic variability is associated with brain glucose levels highlight the need for future studies to investigate the impact of glycemic variability on brain glucose kinetics.
- Subjects
TYPE 1 diabetes; GLYCEMIC index; GLUCOSE transporter genetics; GLYCEMIC control; HYPOGLYCEMIA; HYPOGLYCEMIC agents; BRAIN metabolism; GLUCOSE metabolism; ANIMAL experimentation; BLOOD sugar; COMPARATIVE studies; HYPERGLYCEMIA; MATHEMATICAL models; RESEARCH methodology; MEDICAL cooperation; RATS; RESEARCH; RESEARCH funding; THEORY; EVALUATION research
- Publication
Diabetes, 2019, Vol 68, Issue 1, p163
- ISSN
0012-1797
- Publication type
journal article
- DOI
10.2337/db18-0722