Project 1: Hypoglycemia and the Brain

A study to investigate the impact of frequent hypoglycemia on brain glucose metabolism and functional connectivity.

Hypoglycemic unawareness is a major obstacle to optimal diabetes care, particularly amongst individuals with T1DM and a greater understanding of the central nervous system mechanisms underlying hypoglycemic unawareness will hopefully lead to more effective treatment options for patients with diabetes. In healthy, lean individuals, small glucose decrements (65-70mg/dl) have been shown to activate reward centers in the brain such as the striatum and suppress the executive control centers, resulting in a greater desire to consume food. Amongst individuals with T1DM, and in particular T1DM patients who are unaware of hypoglycemia, there is a progressive blunting of brain responses in cortico-striatal and fronto-parietal neurocircuits in response to mild-moderate hypoglycemia. These findings have implications for understanding why individuals with impaired hypoglycemia awareness fail to respond appropriately to falling blood glucose levels.