Brain scans show why some type 1 diabetics miss low blood sugar cues

February 2, 2018 by Ziba Kashef, Yale University
Credit: Yale University

The brains of people with type 1 diabetes react differently to low blood sugar compared with healthy adults, say Yale researchers.

The findings of their new study, published in the Journal of Clinical Investigation, shed light on why many type 1 diabetics fail to respond to potentially dangerous drops in their levels.

In healthy, non-diabetic adults, a drop in blood sugar stimulates the body to make glucose and also seek food. But many individuals with type 1 diabetes don't have the same responses to reductions in blood sugar that can result from .

To investigate why, the Yale-led team conducted MRI scans of individuals with type 1 diabetes and healthy adults who had been given insulin to induce . The images showed that in healthy individuals, low blood sugar caused changes in four key regions of the brain that are linked to reward, motivation, and decision making.

By contrast, about half of the type 1 diabetics exhibited altered activity only in areas of the brain associated with attention. The rest of the diabetics failed to show any brain changes in response to even mild low blood sugar.

The difference in the two groups of diabetics was that some still had what's called "hypoglycemia awareness"—the ability to sense the physical symptoms of low blood sugar—and the others did not.

The findings explain why some type 1 diabetics who have adapted to having low blood sugar don't respond when their blood sugar gets too low, the researchers said.

"There is a progressive loss of coordinated brain response to low blood sugar as you go from healthy adult to aware and unaware," said Janice Hwang, M.D., assistant professor of medicine and first author on the study. "The first areas in the brain to go are associated with regulating feeding behavior."

The study can also help researchers determine how to restore low blood sugar awareness in patients who have lost it, Hwang noted. New technologies designed to monitor blood sugar, could play a part in that effort, she said.

Explore further: Lower brain glucose levels found in people with obesity, type 2 diabetes

More information: Janice Jin Hwang et al. Hypoglycemia unawareness in type 1 diabetes suppresses brain responses to hypoglycemia, Journal of Clinical Investigation (2018). DOI: 10.1172/JCI97696

Related Stories

Lower brain glucose levels found in people with obesity, type 2 diabetes

October 19, 2017
Glucose levels are reduced in the brains of individuals with obesity and type 2 diabetes compared to lean individuals, according to a new Yale study. The finding might explain disordered eating behavior—and even a higher ...

Exercising safely with diabetes

July 7, 2017
(HealthDay)—Exercise is a powerful tool for managing diabetes.

Fructose is generated in the human brain

February 23, 2017
Fructose, a form of sugar linked to obesity and diabetes, is converted in the human brain from glucose, according to a new Yale study. The finding raises questions about fructose's effects on the brain and eating behavior.

FDA OKs continuous blood sugar monitor without finger pricks (Update)

September 28, 2017
U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.

Study suggests potential connection between low blood sugar and cardiovascular problems

November 3, 2015
Past studies have shown an association between strict control of blood sugar and increased mortality. These studies have also suggested that a consequence of this strict control is low blood sugar (called hypoglycemia), which ...

Size matters when it comes to keeping blood sugar levels in check

February 10, 2017
Keeping blood sugar levels within a safe range is key to managing both type 1 and type 2 diabetes. In a new finding that could lead to fewer complications for diabetes patients, Yale School of Medicine researchers have found ...

Recommended for you

Diabetes drug might also ease heart failure risks

November 12, 2018
(HealthDay)—The diabetes drug Farxiga might do double-duty for patients, helping to ward off another killer, heart failure, new research shows.

Diabetic foot ulcers heal quickly with nitric oxide technology

November 12, 2018
Diabetic foot ulcers can take up to 150 days to heal. A biomedical engineering team wants to reduce it to 21 days.

Marijuana use tied to serious diabetes complication

November 8, 2018
(HealthDay)—People with type 1 diabetes who use marijuana may double their risk of developing a life-threatening complication, a new study suggests.

Researchers report connection between intestinal bacteria and development of diabetes

November 7, 2018
Researchers at Örebro University have, together with a well-known research team in Denmark, developed a method for studying how metabolism in gut bacteria influences health. Their method will now be published in its entirety ...

Genetic factors tied to obesity may protect against diabetes

November 2, 2018
Some genetic variations linked with obesity actually protect against Type 2 diabetes, heart attack and stroke, new findings suggest.

Study shows improved health, reduced overweight and obesity in Pacific-region children

October 30, 2018
A community-randomized clinical trial of the Children's Healthy Living Program (CHL), based at the University of Hawaiʻi at Mānoa, seeking to sustainably prevent and decrease overweight and obese young children and to improve ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.