Increased endogenous glucose production (EGP) is a hallmark of type 2 diabetes mellitus. While there is evidence for central regulation of EGP by activation of hypothalamic ATP-sensitive potassium (KATP) channels in rodents, whether these central pathways contribute to regulation of EGP in humans remains to be determined. Here we present evidence for central nervous system regulation of EGP in humans that is consistent with complementary rodent studies. Oral administration of the KATP channel activator diazoxide under fixed hormonal conditions substantially decreased EGP in nondiabetic humans and Sprague Dawley rats. In rats, comparable doses of oral diazoxide attained appreciable concentrations in the cerebrospinal fluid, and the effects of oral diazoxide were abolished by i.c.v. administration of the KATP channel blocker glibenclamide. These results suggest that activation of hypothalamic KATP channels may be an important regulator of EGP in humans and that this pathway could be a target for treatment of hyperglycemia in type 2 diabetes mellitus.
Preeti Kishore, Laura Boucai, Kehao Zhang, Weijie Li, Sudha Koppaka, Sylvia Kehlenbrink, Anna Schiwek, Yonah B. Esterson, Deeksha Mehta, Samar Bursheh, Ya Su, Roger Gutierrez-Juarez, Radhika Muzumdar, Gary J. Schwartz, Meredith Hawkins
Title and authors | Publication | Year |
---|---|---|
The Role of the Arcuate Nucleus in Regulating Hunger and Satiety in Prader-Willi Syndrome
Höybye C, Petersson M |
Current Issues in Molecular Biology | 2025 |
The insulin resistant brain: impact on whole-body metabolism and body fat distribution.
Heni M |
Diabetologia | 2024 |
Behavioral changes in patients with Prader-Willi syndrome receiving diazoxide choline extended-release tablets compared to the PATH for PWS natural history study
Strong TV, Miller JL, McCandless SE, Gevers E, Yanovski JA, Matesevac L, Bohonowych J, Ballal S, Yen K, Hirano P, Cowen NM, Bhatnagar A |
Journal of Neurodevelopmental Disorders | 2024 |
Brain Defense of Glycemia in Health and Diabetes.
Mirzadeh Z, Faber C |
Diabetes | 2024 |
Exercise as a Therapeutic Strategy for Obesity: Central and Peripheral Mechanisms
Zhang Y, Wang R, Liu T, Wang R |
Metabolites | 2024 |
Clinical Trials in Prader–Willi Syndrome: A Review
Mahmoud R, Kimonis V, Butler MG |
International journal of molecular sciences | 2023 |
Diazoxide Choline Extended-Release Tablet in People With Prader-Willi Syndrome: A Double-Blind, Placebo-Controlled Trial.
Miller JL, Gevers E, Bridges N, Yanovski JA, Salehi P, Obrynba KS, Felner EI, Bird LM, Shoemaker AH, Angulo M, Butler MG, Stevenson D, Abuzzahab J, Barrett T, Lah M, Littlejohn E, Mathew V, Cowen NM, Bhatnagar A |
The Journal of clinical endocrinology and metabolism | 2023 |
Neurochemical Basis of Inter-Organ Crosstalk in Health and Obesity: Focus on the Hypothalamus and the Brainstem
Haspula D, Cui Z |
Cells | 2023 |
Liver insulinization as a driver of triglyceride dysmetabolism.
Cook JR, Hawkins MA, Pajvani UB |
Nature metabolism | 2023 |
Exercise restores brain insulin sensitivity in sedentary overweight and obese adults
Stephanie Kullmann, Thomas Goj, Ralf Veit, Louise Fritsche, Lore Wagner, Patrick Schneeweiss, Miriam Hoene, Christoph Hoffmann, Juergen Machann, Andreas Niess, Hubert Preissl, Andreas Birkenfeld, Andreas Peter, Hans-Ulrich Häring, Andreas Fritsche, Anja Moller, Cora Weigert, Martin Heni |
JCI Insight | 2022 |
Hindbrain insulin controls feeding behavior.
Eerola K, Longo F, Reinbothe TM, Richard JE, Shevchouk OT, López-Ferreras L, Mishra D, Asker M, Tolö J, Miranda C, Musovic S, Olofsson CS, Rorsman P, Skibicka KP |
Molecular Metabolism | 2022 |
Brain insulin resistance and cognitive function: influence of exercise
Malin SK, Stewart NR, Ude AA, Alderman BL |
Journal of applied physiology | 2022 |
Rap1 in the VMH regulates glucose homeostasis
Kentaro Kaneko, Hsiao-Yun Lin, Yukiko Fu, Pradip K Saha, Ana B. De la Puente Gomez, Yong Xu, Kousaku Ohinata, Peter Chen, Alexei Morozov, Makoto Fukuda |
JCI Insight | 2021 |
Nutrient infusion in the dorsal vagal complex controls hepatic lipid and glucose metabolism in rats
RJ Li, B Batchuluun, SY Zhang, MA Abraham, B Wang, YM Lim, JT Yue, TK Lam |
iScience | 2021 |
Brain insulin signalling in metabolic homeostasis and disease
T Scherer, K Sakamoto, C Buettner |
Nature Reviews Endocrinology | 2021 |
The Anti-diabetic Drug Gliquidone Modulates Lipopolysaccharide-Mediated Microglial Neuroinflammatory Responses by Inhibiting the NLRP3 Inflammasome
J Kim, JH Park, K Shah, SJ Mitchell, K Cho, HS Hoe |
Frontiers in aging neuroscience | 2021 |
Somatostatin-evoked Aβ catabolism in the brain: Mechanistic involvement of α-endosulfine-KATP channel pathway
N Watamura, N Kakiya, P Nilsson, S Tsubuki, N Kamano, M Takahashi, S Hashimoto, H Sasaguri, T Saito, TC Saido |
Molecular Psychiatry | 2021 |
Insulin actions on hypothalamic glucose-sensing neurones
Garcia SM, Hirschberg PR, Sarkar P, Siegel DM, Teegala SB, Vail GM, Routh VH |
Journal of Neuroendocrinology | 2021 |
Central K ATP Channels Modulate Glucose Effectiveness in Humans and Rodents
M Carey, E Lontchi-Yimagou, W Mitchell, S Reda, K Zhang, S Kehlenbrink, S Koppaka, SR Maginley, S Aleksic, S Bhansali, DM Huffman, M Hawkins |
Diabetes | 2020 |
Interaction of glucose sensing and leptin action in the brain
RJ Li, SY Zhang, TK Lam |
Molecular Metabolism | 2020 |
The integrative biology of type 2 diabetes
M Roden, GI Shulman |
Nature | 2019 |
Is the Brain a Key Player in Glucose Regulation and Development of Type 2 Diabetes?
MH Lundqvist, K Almby, N Abrahamsson, JW Eriksson |
Frontiers in physiology | 2019 |
Ventromedial hypothalamus glucose‐inhibited neurones: A role in glucose and energy homeostasis?
PR Hirschberg, P Sarkar, SB Teegala, VH Routh |
Journal of Neuroendocrinology | 2019 |
Structure-Activity Relationships, Pharmacokinetics, and Pharmacodynamics of the Kir6.2/SUR1-Specific Channel Opener VU0071063
SV Kharade, JV Sanchez-Andres, MG Fulton, EL Shelton, AL Blobaum, DW Engers, CS Hofmann, PK Dadi, L Lantier, DA Jacobson, CW Lindsley, JS Denton |
The Journal of pharmacology and experimental therapeutics | 2019 |
A randomized pilot efficacy and safety trial of diazoxide choline controlled-release in patients with Prader-Willi syndrome
V Kimonis, A Surampalli, M Wencel, JA Gold, NM Cowen, MS Buchowski |
PloS one | 2019 |
Clinical Trial of the Potassium Channel Activator Diazoxide for Major Depressive Disorder Halted Due to Intolerability:
B Kadriu, S Yuan, C Farmer, AC Nugent, MS Lener, MJ Niciu, M Park, A Yazdian, ED Ballard, FA Henn, ID Henter, LT Park, CA Zarate |
Journal of Clinical Psychopharmacology | 2018 |
Neuronal control of peripheral insulin sensitivity and glucose metabolism
J Ruud, SM Steculorum, JC Brüning |
Nature Communications | 2017 |
Deletion of hepatic carbohydrate response element binding protein (ChREBP) impairs glucose homeostasis and hepatic insulin sensitivity in mice
T Jois, W Chen, V Howard, R Harvey, K Youngs, C Thalmann, P Saha, L Chan, MA Cowley, MW Sleeman |
Molecular Metabolism | 2017 |
Opioid Receptor Activation Impairs Hypoglycemic Counterregulation in Humans
M Carey, R Gospin, A Goyal, N Tomuta, O Sandu, A Mbanya, E Lontchi-Yimagou, R Hulkower, H Shamoon, I Gabriely, M Hawkins |
Diabetes | 2017 |
Central Regulation of Glucose Production May Be Impaired in Type 2 Diabetes
YB Esterson, M Carey, L Boucai, A Goyal, P Raghavan, K Zhang, D Mehta, D Feng, L Wu, S Kehlenbrink, S Koppaka, P Kishore, M Hawkins |
Diabetes | 2016 |
Is Brain Insulin Action Relevant to the Control of Plasma Glucose in Humans?: Figure 1
DS Edgerton, AD Cherrington |
Diabetes | 2015 |
Gut-brain mechanisms controlling glucose homeostasis
JM Scarlett, MW Schwartz |
F1000prime reports | 2015 |
The Classically Cardioprotective Agent Diazoxide Elicits Arrhythmias in Type 2 Diabetes Mellitus
C Xie, J Hu, LJ Motloch, BS Karam, FG Akar |
Journal of the American College of Cardiology | 2015 |
The interplay between metabolic homeostasis and neurodegeneration: insights into the neurometabolic nature of amyotrophic lateral sclerosis
ST Ngo, FJ Steyn |
Cell Regeneration | 2015 |
Impaired insulin action in the human brain: causes and metabolic consequences
M Heni, S Kullmann, H Preissl, A Fritsche, HU Häring |
Nature Reviews Endocrinology | 2015 |
Glucagon and lipid signaling in the hypothalamus
MP LaPierre, MA Abraham, BM Filippi, JT Yue, TK Lam |
Mammalian Genome | 2014 |
Hepatic branch vagus nerve plays a critical role in the recovery of post-ischemic glucose intolerance and mediates a neuroprotective effect by hypothalamic orexin-a
S Harada, Y Yamazaki, S Koda, S Tokuyama |
PloS one | 2014 |
Hypothalamic glucagon signals through the KATP channels to regulate glucose production
MA Abraham, JT Yue, MP LaPierre, GA Rutter, PE Light, BM Filippi, TK Lam |
Molecular Metabolism | 2014 |
Evidence for Central Regulation of Glucose Metabolism
M Carey, S Kehlenbrink, M Hawkins |
The Journal of biological chemistry | 2013 |
Cooperation between brain and islet in glucose homeostasis and diabetes
MW Schwartz, RJ Seeley, MH Tschöp, SC Woods, GJ Morton, MG Myers, D D’Alessio |
Nature | 2013 |
Multifunctional role of astrocytes as gatekeepers of neuronal energy supply
JL Stobart, CM Anderson |
Frontiers in cellular neuroscience | 2013 |
Reduced adipose tissue macrophage content is associated with improved insulin sensitivity in thiazolidinedione-treated diabetic humans
S Koppaka, S Kehlenbrink, M Carey, W Li, E Sanchez, DE Lee, H Lee, J Chen, E Carrasco, P Kishore, K Zhang, M Hawkins |
Diabetes | 2013 |
Insulin and glucagon signaling in the central nervous system
BM Filippi, MA Abraham, JT Yue, TK Lam |
Reviews in Endocrine and Metabolic Disorders | 2013 |
Hypothalamic inhibition of acetyl-CoA carboxylase stimulates hepatic counter-regulatory response independent of AMPK activation in rats
GA Santos, VD Pereira, EA Roman, L Ignacio-Souza, DC Vitorino, RF de Moura, DS Razolli, AS Torsoni, LA Velloso, MA Torsoni |
PloS one | 2013 |
Role of the ventral striatum in developing anorexia nervosa
AK Fladung, UM Schulze, F Schöll, K Bauer, G Grön |
Translational Psychiatry | 2013 |
Evidence against a physiologic role for acute changes in CNS insulin action in the rapid regulation of hepatic glucose production
CJ Ramnanan, DS Edgerton, AD Cherrington |
Cell Metabolism | 2012 |
Postprandial administration of intranasal insulin intensifies satiety and reduces intake of palatable snacks in women
M Hallschmid, S Higgs, M Thienel, V Ott, H Lehnert |
Diabetes | 2012 |
Linking Inflammation to the Brain-Liver Axis
PI Mighiu, BM Filippi, TK Lam |
Diabetes | 2012 |
Interaction between the central and peripheral effects of insulin in controlling hepatic glucose metabolism in the conscious dog
CJ Ramnanan, G Kraft, MS Smith, B Farmer, D Neal, PE Williams, M Lautz, T Farmer, EP Donahue, AD Cherrington, DS Edgerton |
Diabetes | 2012 |
Is Insulin Action in the Brain Clinically Relevant?
BM Filippi, PI Mighiu, TK Lam |
Diabetes | 2012 |
Elevated NEFA levels impair glucose effectiveness by increasing net hepatic glycogenolysis
S Kehlenbrink, S Koppaka, M Martin, R Relwani, MH Cui, JH Hwang, Y Li, R Basu, M Hawkins, P Kishore |
Diabetologia | 2012 |
Bursting for exploration.
da Silva JA, Costa RM |
Nature Neuroscience | 2012 |