Glycemic Variability and Brain Glucose Levels in Type 1 Diabetes.

Autor: Hwang JJ; Section of Endocrinology, Yale School of Medicine, New Haven, CT janice.hwang@yale.edu., Jiang L; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT., Sanchez Rangel E; Section of Endocrinology, Yale School of Medicine, New Haven, CT., Fan X; Section of Endocrinology, Yale School of Medicine, New Haven, CT., Ding Y; Section of Endocrinology, Yale School of Medicine, New Haven, CT., Lam W; Section of Endocrinology, Yale School of Medicine, New Haven, CT., Leventhal J; Section of Endocrinology, Yale School of Medicine, New Haven, CT., Dai F; Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT., Rothman DL; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT., Mason GF; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.; Department of Psychiatry, Yale School of Medicine, New Haven, CT., Sherwin RS; Section of Endocrinology, Yale School of Medicine, New Haven, CT.
Jazyk: angličtina
Zdroj: Diabetes [Diabetes] 2019 Jan; Vol. 68 (1), pp. 163-171. Date of Electronic Publication: 2018 Oct 16.
DOI: 10.2337/db18-0722
Abstrakt: 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/m 2 ; HbA 1c 7.6 ± 0.3) and nine healthy control participants (age 32 ± 4; BMI 23.1 ± 0.8; HbA 1c 5.0 ± 0.1) wore a continuous glucose monitor (Dexcom) to measure hypoglycemia, hyperglycemia, and glycemic variability for 5 days followed by 1 H 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.
(© 2018 by the American Diabetes Association.)
Databáze: MEDLINE
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