Hippocampal Neurochemical Profile and Glucose Transport Kinetics in Patients With Type 1 Diabetes

Author:

Bednařík Petr1234,Henry Pierre-Gilles1,Khowaja Amir2,Rubin Nathan5,Kumar Anjali2,Deelchand Dinesh1,Eberly Lynn E5,Seaquist Elizabeth2,Öz Gülin1,Moheet Amir2ORCID

Affiliation:

1. Center for Magnetic Reson  ance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota

2. Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, Minnesota

3. High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria

4. Department of Imaging Methods, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic

5. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota

Abstract

Abstract Context Longstanding type 1 diabetes (T1D) may lead to alterations in hippocampal neurochemical profile. Upregulation of hippocampal glucose transport as a result of recurrent exposure to hypoglycemia may preserve cognitive function during future hypoglycemia in subjects with T1D and impaired awareness of hypoglycemia (IAH). The effect of T1D on hippocampal neurochemical profile and glucose transport is unknown. Objective To test the hypothesis that hippocampal neurochemical composition is altered in T1D and glucose transport is upregulated in T1D with IAH. Design and participants Hippocampal neurochemical profile was measured with single-voxel magnetic resonance spectroscopy at 3T during euglycemia in 18 healthy controls (HC), 10 T1D with IAH, and 12 T1D with normal awareness to hypoglycemia (NAH). Additionally, 12 HC, 8 T1D-IAH, and 6 T1D-NAH were scanned during hyperglycemia to assess hippocampal glucose transport with metabolic modeling. Setting University medical center. Main Outcome Measures Concentrations of hippocampal neurochemicals measured during euglycemia and ratios of maximal transport rate to cerebral metabolic rate of glucose (Tmax/CMRGlc), derived from magnetic resonance spectroscopy–measured hippocampal glucose as a function of plasma glucose. Results Comparison of hippocampal neurochemical profile revealed no group differences (HC, T1D, T1D-IAH, and T1D-NAH). The ratio Tmax/CMRGlc was not significantly different between the groups, T1D-IAH (1.58 ± 0.09) and HC (1.65 ± 0.07, P = 0.54), between T1D-NAH (1.50 ± 0.09) and HC (P = 0.19), and between T1D-IAH and T1D-NAH (P = 0.53). Conclusions Subjects with T1D with sufficient exposure to recurrent hypoglycemia to create IAH did not have alteration of Tmax/CMRglc or neurochemical profile compared with participants with T1D-NAH or HC.

Funder

Clinical and Translational Science Institute

National Institutes of Health

Brain and Behavior Research Foundation

Marie Skłodowska-Curie

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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