Neuronal Activation in Exercise-Induced Hypoglycemia Associated Autonomic Failure
Ana Maria Arbelaez, M.D., MSCI
- Center for Metabolism and Immunity
Interdisciplinary Research Initiative
2/1/2009 - 1/31/2013
Philip Cryer, Tamara Hershey, Tom Videen, W. Todd Cade
Each year, more than 15,000 children are diagnosed with type 1 diabetes (T1DM) in the US. The goal of diabetes therapy in children is to support adequate growth, development and emotional maturation at the same time that patient achieves good blood sugar control. Tight sugar control in children with T1DM results in recurrent episodes of low blood sugar (hypoglycemia), and causes death. Hypoglycemia undermines attempts to achieve normal blood sugar control. Exercise plays a big part in the lives of children and teens with T1DM. Unfortunately prior exercise and prior low blood sugar episodes blunt the hormone and symptom responses to subsequent hypoglycemia, causing a vicious cycle of recurrent low blood sugars in patients with diabetes. This phenomenon is known as hypoglycemia associated autonomic failure (HAAF). The mechanism(s) that cause it are not known, but is often assumed to reside in the brain. A multidisciplinary team of researchers at Washington University is trying to find why this phenomenon happens and how it happens. They believe that a region of the brain called the thalamus is reducing the hormone and symptom responses to low blood sugars when previous exercise has occurred. Better understanding of this phenomenon will enable scientists to find strategies to reduce death and complications related to low blood glucose in patients with type1 diabetes within the next decade.