ArticleThe Journal of clinical endocrinology and metabolism2013
Increased brain transport and metabolism of acetate in hypoglycemia unawareness.
Article in The Journal of clinical endocrinology and metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Trial
- Effect of lactate administration on cerebral blood flow during hypoglycemia in people with type 1 diabetes.BMJ open diabetes research & care · 2022Trial
- Hypoglycemia unawareness in type 1 diabetes suppresses brain responses to hypoglycemia.The Journal of clinical investigation · 2018Trial
- Reversible alterations of brain acetate metabolism associated with alcohol consumption.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Measurement of brain glucose metabolism in obesity and diabetes.Diabetologia · 2025Review
- Article
- Monitoring the Neurotransmitter Response to Glycemic Changes Using an Advanced Magnetic Resonance Spectroscopy Protocol at 7T.Frontiers in neurology · 2021Article
- Consuming a ketogenic diet leads to altered hypoglycemic counter-regulation in mice.Journal of diabetes and its complications · 2020Article
- Ventromedial hypothalamus glucose-inhibited neurones: A role in glucose and energy homeostasis?Journal of neuroendocrinology · 2020Review
- Effect of lactate administration on brain lactate levels during hypoglycemia in patients with type 1 diabetes.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019Article
- Gut microbial metabolites in obesity, NAFLD and T2DM.Nature reviews. Endocrinology · 2019Review
- Glial acetate metabolism is increased following a 72-h fast in metabolically healthy men and correlates with susceptibility to hypoglycemia.Acta diabetologica · 2018Article
- Imaging and spectroscopic approaches to probe brain energy metabolism dysregulation in neurodegenerative diseases.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017Review
- Brain glucose metabolism during hypoglycemia in type 1 diabetes: insights from functional and metabolic neuroimaging studies.Cellular and molecular life sciences : CMLS · 2016Review
- Metabolic Alterations Associated to Brain Dysfunction in Diabetes.Aging and disease · 2015Review
- Mechanisms of hypoglycemia unawareness and implications in diabetic patients.World journal of diabetes · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
contextIntensive insulin therapy reduces the risk for long-term complications in patients with type 1 diabetes mellitus (T1DM) but increases the risk for hypoglycemia-associated autonomic failure (HAAF), a syndrome that includes hypoglycemia unawareness and defective glucose counterregulation (reduced epinephrine and glucagon responses to hypoglycemia).
objectiveThe objective of the study was to address mechanisms underlying HAAF, we investigated whether nonglucose fuels such as acetate, a monocarboxylic acid (MCA), can support cerebral energetics during hypoglycemia in T1DM individuals with hypoglycemia unawareness.
designMagnetic resonance spectroscopy was used to measure brain transport and metabolism of [2-(13)C]acetate under hypoglycemic conditions.
settingThe study was conducted at the Yale Center for Clinical Investigation Hospital Research Unit, Yale Magnetic Resonance Research Center. PATIENTS AND OTHER
participantsT1DM participants with moderate to severe hypoglycemia unawareness (n = 7), T1DM controls without hypoglycemia unawareness (n = 5), and healthy nondiabetic controls (n = 10) participated in the study. MAIN OUTCOME MEASURE(S): Brain acetate concentrations, (13)C percent enrichment of glutamine and glutamate, and absolute rates of acetate metabolism were measured.
resultsAbsolute rates of acetate metabolism in the cerebral cortex were 1.5-fold higher among T1DM/unaware participants compared with both control groups during hypoglycemia (P = .001). Epinephrine levels of T1DM/unaware subjects were significantly lower than both control groups (P < .05). Epinephrine levels were inversely correlated with levels of cerebral acetate use across the entire study population (P < .01), suggesting a relationship between up-regulated brain MCA use and HAAF.
conclusionIncreased MCA transport and metabolism among T1DM individuals with hypoglycemia unawareness may be a mechanism to supply the brain with nonglucose fuels during episodes of acute hypoglycemia and may contribute to the syndrome of hypoglycemia unawareness, independent of diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.