Central Mechanisms of Glucose Sensing and Counterregulation in Defense of Hypoglycemia

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations


Glucose homeostasis requires an organism to rapidly respond to changes in plasma glucose concentrations. Iatrogenic hypoglycemia as a result of treatment with insulin or sulfonylureas is the most common cause of hypoglycemia in humans and is generally only seen in patients with diabetes who take these medications. The first response to a fall in glucose is the detection of impending hypoglycemia by hypoglycemia-detecting sensors, including glucose-sensing neurons in the hypothalamus and other regions. This detection is then linked to a series of neural and hormonal responses that serve to prevent the fall in blood glucose and restore euglycemia. In this review, we discuss the current state of knowledge about central glucose sensing and how detection of a fall in glucose leads to the stimulation of counterregulatory hormone and behavior responses. We also review how diabetes and recurrent hypoglycemia impact glucose sensing and counterregulation, leading to development of impaired awareness of hypoglycemia in diabetes.

Original languageEnglish (US)
Pages (from-to)768-788
Number of pages21
JournalEndocrine reviews
Issue number3
StatePublished - Dec 24 2018

Bibliographical note

Publisher Copyright:
© 2019.


Dive into the research topics of 'Central Mechanisms of Glucose Sensing and Counterregulation in Defense of Hypoglycemia'. Together they form a unique fingerprint.

Cite this