title: Recurrent hypoglycemia: boosting the brain's metabolic flexibility.
abstract: For people with diabetes, recurrent episodes of hypoglycemia limit the brain's ability to sense dangerously low blood sugar levels. In this issue of the JCI, the mechanisms behind this clinical problem of hypoglycemia unawareness are addressed by Herzog et al. The authors provide compelling evidence that recurrent hypoglycemia enhances transport of lactate into the brain and, although not itself a major alternative fuel source, lactate may preserve neuronal function during hypoglycemia by maintaining neuronal glucose metabolism. These findings redefine our understanding of the brain's metabolic adaptations that result from recurrent hypoglycemia.
authors.affiliation: Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University, St. Louis, Missouri 63110, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Litvin
authors.forename: Amy L
authors.initials: AL
authors.lastname: Clark
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Fisher
mesh_terms: D000818:Animals; D006801:Humans; D007003:Hypoglycemia / Q000378:metabolism*; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D009474:Neurons / Q000378:metabolism*
chemical_list: D019344:Lactic Acid
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