Hypothalamic AMP-activated protein kinase activation with AICAR amplifies counterregulatory responses to hypoglycemia in a rodent model of type 1 diabetes

X Fan, Y Ding, S Brown, L Zhou… - American Journal …, 2009 - journals.physiology.org
X Fan, Y Ding, S Brown, L Zhou, M Shaw, MC Vella, H Cheng, EC McNay, RS Sherwin…
American Journal of Physiology-Regulatory, Integrative and …, 2009journals.physiology.org
In nondiabetic rodents, AMP-activated protein kinase (AMPK) plays a role in the glucose-
sensing mechanism used by the ventromedial hypothalamus (VMH), a key brain region
involved in the detection of hypoglycemia. However, AMPK is regulated by both hyper-and
hypoglycemia, so whether AMPK plays a similar role in type 1 diabetes (T1DM) is unknown.
To address this issue, we used four groups of chronically catheterized male diabetic BB rats,
a rodent model of autoimmune T1DM with established insulin—requiring diabetes (40±4 …
In nondiabetic rodents, AMP-activated protein kinase (AMPK) plays a role in the glucose-sensing mechanism used by the ventromedial hypothalamus (VMH), a key brain region involved in the detection of hypoglycemia. However, AMPK is regulated by both hyper- and hypoglycemia, so whether AMPK plays a similar role in type 1 diabetes (T1DM) is unknown. To address this issue, we used four groups of chronically catheterized male diabetic BB rats, a rodent model of autoimmune T1DM with established insulin—requiring diabetes (40 ± 4 pmol/l basal c-peptide). Two groups were subjected to 3 days of recurrent hypoglycemia (RH), while the other two groups were kept hyperglycemic [chronic hyperglycemia (CH)]. All groups subsequently underwent hyperinsulinemic hypoglycemic clamp studies on day 4 in conjunction with VMH microinjection with either saline (control) or AICAR (5-aminoimidazole-4-carboxamide) to activate AMPK. Compared with controls, local VMH application of AICAR during hypoglycemia amplified both glucagon [means ± SE, area under the curve over time (AUC/t) 144 ± 43 vs. 50 ± 11 ng·l−1·min−1; P < 0.05] and epinephrine [4.27 ± 0.96 vs. 1.06 ± 0.26 nmol·l−1·min−1; P < 0.05] responses in RH-BB rats, and amplified the glucagon [151 ± 22 vs. 85 ± 22 ng·l−1·min−1; P < 0.05] response in CH-BB rats. We conclude that VMH AMPK also plays a role in glucose-sensing during hypoglycemia in a rodent model of T1DM. Moreover, our data suggest that it may be possible to partially restore the hypoglycemia-specific glucagon secretory defect characteristic of T1DM through manipulation of VMH AMPK.
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