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Altered functional connectivity during hypoglycaemia in type 1 diabetes.

Peter Jacob1, Munachiso Nwokolo1, Sally M Cordon2

  • 1Diabetes Research Group (Denmark Hill), Faculty of Life Sciences and Medicine, King's College London, London, UK.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|February 25, 2022
PubMed
Summary

Brain connectivity changes during hypoglycemia reveal that people with type 1 diabetes and normal awareness recruit specific brain networks. Impaired awareness is linked to altered connectivity in the right inferior frontal gyrus.

Keywords:
Hypoglycaemiaimpaired awareness of hypoglycaemianeuroimagingresting state networkstype 1 diabetes

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Area of Science:

  • Neuroscience
  • Endocrinology
  • Psychology

Background:

  • Hypoglycemia (low blood sugar) triggers complex brain responses.
  • Type 1 diabetes can lead to impaired hypoglycemia awareness.
  • Brain network connectivity is crucial for behavioral responses to hypoglycemia.

Purpose of the Study:

  • To investigate differences in brain connectivity during hypoglycemia.
  • To compare brain activity in people without diabetes (ND), with normal awareness hypoglycemia (NAH), and impaired awareness hypoglycemia (IAH).

Main Methods:

  • Used two-step hyperinsulinaemic hypoglycemic clamps.
  • Acquired BOLD fMRI data at euglycemia and hypoglycemia.
  • Analyzed connectivity in default mode (DMN), salience (SN), central executive (CEN) networks, thalamus, and right inferior frontal gyrus (RIFG).

Main Results:

  • NAH participants showed hypoglycemia-induced changes in DMN, SN, and CEN connectivity.
  • ND and IAH participants did not exhibit these network-wide changes.
  • IAH participants showed reduced RIFG connectivity, unlike ND and NAH groups.

Conclusions:

  • Hypoglycemia recruits DMN and SN in type 1 diabetes with preserved awareness, but not in impaired awareness.
  • Altered RIFG connectivity may underlie impaired hypoglycemia awareness in type 1 diabetes.