Hypoglycemia

Hypoglycemia (blood glucose levels below about 70 mg/dL) is a major challenge for Type 1 (and increasingly Type 2) diabetic patients, constituting one of the major obstacles to optimum treatment of the disease. Hypoglycemia usually occurs because the normal counterregulatory responses to correct low blood glucose often fail in diabetic patients, usually after previous exposure to hypoglycemia. This failure appears to be due to impairments in hypothalamic neurons to sense glucose. Recent studies have implicated specific molecular processes (e.g., BDNF control of GABAergic neurons) in this failure, but some therapies (e.g., the opioid antagonist naloxone and the β-2 AR agonist formoterol) show promise in reversing these impairments.