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J Clin Invest. 2006 Jun;116(6):1470-3.

Mechanisms of sympathoadrenal failure and hypoglycemia in diabetes.

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1
Division of Endocrinology, Metabolism and Lipid Research, General Clinical Research Center, and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA. pcryer@wustl.edu

Abstract

A reduced sympathoadrenal response, induced by recent antecedent hypoglycemia, is the key feature of hypoglycemia-associated autonomic failure (HAAF) and, thus, the pathogenesis of iatrogenic hypoglycemia in diabetes. Understanding of the mechanism(s) of that reduced response awaits new insight into its basic molecular, cellular, organ, and whole-body physiology and pathophysiology in experimental models. In this issue of the JCI, McCrimmon and colleagues report that application of urocortin I (a corticotrophin-releasing factor receptor-2 agonist) to the ventromedial hypothalamus reduces the glucose counterregulatory response to hypoglycemia in rats (see the related article beginning on page 1723). Thus, hypothalamic urocortin I release during antecedent hypoglycemia is, among other possibilities, a potential mechanism of HAAF.

PMID:
16741570
PMCID:
PMC1464914
DOI:
10.1172/JCI28735
[Indexed for MEDLINE]
Free PMC Article
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