Cerebral Vascular Disease Research Laboratories, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Ave, NRB/203E, Miami, FL, 33136, USA.
Mol Neurobiol. 2018 Dec;55(12):9075-9088. doi: 10.1007/s12035-018-1044-6. Epub 2018 Apr 10.
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.
糖尿病是一种影响全球数百万人的代谢疾病。世界总医疗支出的很大一部分用于治疗糖尿病。低血糖是抗糖尿病药物治疗的严重后果，因为它会引起大脑的代谢改变。代谢改变是介导低血糖相关大脑功能变化的核心机制之一。急性、慢性和/或复发性低血糖会调节多种代谢途径，并且暴露于低血糖会增加大脑中替代呼吸底物的消耗，如酮体、糖原和单羧酸。本综述的目的是讨论低血糖引起的大脑代谢改变在葡萄糖代偿、摄取、利用和代谢、细胞呼吸、氨基酸和脂质代谢以及其他能量来源的意义。本综述总结了关于糖尿病和非糖尿病患者低血糖引起的大脑代谢变化的信息，以及它们可能影响大脑功能的方式。
