Glucose ingestion fails to inhibit hypothalamic neuronal activity in patients with type 2 diabetes.
OBJECTIVE
The hypothalamus plays a critical role in the regulation of energy balance and fuel flux. Glucose ingestion inhibits hypothalamic neuronal activity in healthy humans. We hypothesized that hypothalamic neuronal activity in response to an oral glucose load would be altered in patients with type 2 diabetes.


METHODS
In this randomized, single blind, case-control study, 7 type 2 diabetic men (BMI 27.9 +/- 2.0 kg/m(2)) and 10 age-matched healthy men (BMI 26.1 +/- 3.2 kg/m(2)) were scanned twice for 38 min on separate days using functional magnetic resonance imaging. After 8 min, they ingested either a glucose solution (75 g in 300 ml water) or water (300 ml).


RESULTS
Glucose ingestion resulted in a prolonged significant blood oxygen level-dependent signal decrease in the upper and lower hypothalamus in healthy subjects but not in diabetic patients.


CONCLUSIONS
Glucose ingestion fails to inhibit hypothalamic neuronal activity in patients with type 2 diabetes. Failure of neural circuits to properly adapt to nutrient ingestion may contribute to metabolic imbalance in type 2 diabetic patients.
Leiden University Medical Center, Department of Endocrinology and Metabolic Disease, C4-83, P.O. Box 9600, 2300 RC, Leiden, Netherlands.
Solrun
S
Vidarsdottir
Paul A M
PA
Smeets
Diane L
DL
Eichelsheim
Matthias J P
MJ
van Osch
Max A
MA
Viergever
Johannes A
JA
Romijn
Jeroen
J
van der Grond
Hanno
H
Pijl
D000284:Administration, Oral; D049628:Body Size; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D002149:Energy Intake; D004734:Energy Metabolism; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000187:drug effects / Q000502:physiology*; D012016:Reference Values; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology; D016037:Single-Blind Method; D014280:Triglycerides / Q000097:blood
D007328:Insulin; D014280:Triglycerides; D005947:Glucose