Related Experiment Video
Updated: Jun 8, 2026

Accelerated Type 1 Diabetes Induction in Mice by Adoptive Transfer of Diabetogenic CD4+ T Cells
Published on: May 6, 2013
CD36 deficiency predisposing young children to fasting hypoglycemia
Hironori Nagasaka1, Tohru Yorifuji, Tomozumi Takatani
1Division of Metabolism, Chiba Children's Hospital, Chiba 266-0007, Japan. nagasa-hirono@k2.dion.ne.jp
Insights
Type I CD36 deficiency, a defect in fatty acid transport, significantly predisposes preschool children to hypoglycemia. This contrasts with type II CD36 deficiency, which does not show this predisposition.
Area of Science:
- Biochemistry
- Pediatrics
- Metabolic Disorders
Background:
- Fatty acid (FA) β-oxidation defects are known causes of hypoglycemia.
- CD36 is a crucial membrane transporter for long-chain fatty acids.
Purpose of the Study:
- To investigate whether CD36 deficiency predisposes children to hypoglycemia.
- To differentiate the hypoglycemic risk associated with different types of CD36 deficiency.
Main Methods:
- Compared carbohydrate and FA metabolism in 51 hypoglycemic children and 49 controls during prolonged fasting (12-16 hours).
- Assessed CD36 expression on platelets and monocytes to identify phenotypes.
- Analyzed blood glucose, insulin, free fatty acid (FFA), and ketone body concentrations.
Main Results:
- Six children had type I CD36 deficiency; none of the controls did. Hypoglycemia was recurrent in this group.
- Type I CD36 deficiency group exhibited significantly lower blood glucose and insulin levels compared to controls and other hypoglycemic groups.
- Free FA levels were elevated 1.5-2.0 fold in type I CD36 deficiency, while ketone bodies were lower.
Conclusions:
- Type I CD36 deficiency is a significant risk factor for hypoglycemia in preschool children.
- Type II CD36 deficiency does not appear to predispose children to hypoglycemia.
- CD36's role in fatty acid transport is critical for maintaining glucose homeostasis during fasting.
Abstract:
Fatty acid (FA) β-oxidation defects cause hypoglycemia. Our aim was to determine if CD36--a membrane transporter for long-chain FAs--deficiency predisposes children to hypoglycemia. After overnight fasting, we measured parameters for carbohydrate and FA metabolisms at 12-, 14-, and 16-hour fasting points in 51 preschool children with histories of episodic hypoglycemia and 49 age-matched healthy controls. Simultaneously, the expressions of CD36 on platelets and monocytes were examined to determine the phenotypes. Six of the 51 hypoglycemic children and none of the 49 control children were diagnosed as having type I CD36 deficiency. Four and 3 children were diagnosed as having type II CD36 deficiency, respectively. Hypoglycemia was often recurrent in the type I CD36 group. At any fasting point, the type I CD36 group showed significantly lower blood glucose and insulin concentrations than the other groups: glucose, P < .001 vs control group and P < .01 or P < .001 vs type II/wild-type CD36 hypoglycemic groups; insulin, P < .001 vs control group and P < .01 vs type II/wild-type CD36 hypoglycemic groups. Free FA concentration in the type I group was always 1.5- to 2.0-fold higher than that in the other groups, whereas the total ketone body concentration was consistently about two thirds of that in the other groups. Among the type II, wild-type, and control groups, there were no significant differences in the parameters except that the wild-type group showed significantly lower FFA concentration (P < .05). These results suggested that type I CD36 deficiency but not type II CD36 deficiency predisposes preschool children to hypoglycemia.
Related Concept Videos
Hypoglycemia and Glucagon
Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Hypoglycemia
Type I Diabetes I: Introduction
Inborn Errors of Metabolism
Type I Diabetes III: Clinical Manifestations

