Functional Connectivity of Insula, Basal Ganglia, and Prefrontal Executive Control Networks during Hypoglycemia in Type 1 Diabetes.
Nicolas R BoloGail MusenDonald C SimonsonLisa D NickersonVeronica L FloresTamar SiracusaBrandon HagerIn Kyoon LyooPerry F RenshawAlan M JacobsonPublished in: The Journal of neuroscience : the official journal of the Society for Neuroscience (2015)
The major factor limiting improved glucose control in type 1 diabetes is the significant increase in hypoglycemia associated with insulin treatment. Repeated exposure to hypoglycemia alters patients' ability to recognize the autonomic and neuroglycopenic symptoms associated with low plasma glucose levels. We examined brain resting state networks during the induction of hypoglycemia in diabetic and control subjects and found differences in networks involved in sensorimotor function, cognition, and interoceptive awareness that were related to chronic levels of glycemic control. These findings identify brain regions that are sensitive to variations in plasma glucose levels and may also provide a basis for understanding the mechanisms underlying the increased incidence of cognitive impairment and affective disorders seen in patients with diabetes.
Keyphrases
- functional connectivity
- resting state
- glycemic control
- type diabetes
- blood glucose
- cognitive impairment
- insulin resistance
- end stage renal disease
- ejection fraction
- weight loss
- cardiovascular disease
- newly diagnosed
- prognostic factors
- heart rate variability
- risk factors
- peritoneal dialysis
- working memory
- heart rate
- depressive symptoms
- blood brain barrier
- patient reported outcomes
- multiple sclerosis
- skeletal muscle
- replacement therapy
- drug induced
- brain injury