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July 18, 2019 Medical Grand Rounds Recap

July 23, 2019
by Julie Parry

The July 18, 2019 Department of Internal Medicine’s Medical Grand Rounds, “Sugar and the Brain: Insights from Clinical Studies,” was presented by Janice Jin Hwang, MD, assistant professor of medicine (endocrinology).

Hwang discussed two patients with varying blood glucose levels and differing symptoms of hypoglycemia, or low blood sugar, despite drastic differences in their A1C. This led Hwang to look into why some people react differently to various glucose levels and how the brain functions while in a state of hypoglycemia and hyperglycemia.

She asked whether a patient could lose their hypoglycemia awareness and not realize that they needed to eat to bring up their blood sugar. Hwang and team designed a study using novel neuroimaging and induced controlled hypoglycemia in the test subjects. They found in the research that in T1DM and in particular T1DM-Unaware patients, there is a progressive blunting of brain responses in response to mild-moderate hypoglycemia, which could help to explain why “individuals with impaired hypoglycemia awareness fail to respond appropriately to falling blood glucose levels.” Hwang also cited looking into the correlation between obesity and blood glucose levels.

She stressed that more work needed to be done to identify the factors that regulate glucose transport and metabolism in the brain.

Hwang also discussed some open clinical trials and the important of research.

To learn more about Hwang’s work and watch Medical Grand Rounds, Yale faculty can review the video.

Submitted by Julie Parry on July 23, 2019