{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T13:55:03Z","timestamp":1758808503391},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2006,2,27]],"date-time":"2006-02-27T00:00:00Z","timestamp":1140998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2006,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> The mechanisms responsible for the progressive failure of hypoglycaemia counterregulation in long\u2010standing type 1 diabetes are poorly understood. Increased brain glucose uptake during hypoglycaemia or alterations of brain energy metabolism could effect glucose sensing by the brain and thus contribute to hypoglycaemia\u2010associated autonomic failure.<\/jats:p><jats:p><jats:bold>Materials and methods\u2002<\/jats:bold> Type 1 diabetic patients (T1DM) and healthy volunteers (CON) were studied before, during and after a hypoglycaemic (50\u00a0mg\u00a0dL<jats:sup>\u22121<\/jats:sup>) hyperinsulinaemic (1\u00b75\u00a0mU\u00a0kg<jats:sup>\u22121<\/jats:sup>\u00a0min<jats:sup>\u22121<\/jats:sup>) clamp test. The <jats:sup>1<\/jats:sup>H magnetic resonance spectroscopy of the occipital lobe of the brain was performed employing the STEAM localization technique. The water signal was suppressed by the modified SWAMP method. All spectra were acquired on a 3 Tesla scanner (80\u00a0cm MEDSPEC\u2010DBX, Bruker Medical, Ettlingen, Germany) using a 10\u2010cm diameter surface coil.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> During hypoglycaemia, T1DM showed blunted endocrine counterregulation. At baseline the brain tissue glucose\u00a0:\u00a0creatine ratio was lower in CON than in T1DM (CON 0\u00b713\u00a0\u00b1\u00a00\u00b705 vs. T1DM 0\u00b719\u00a00\u00b711; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701). During hypoglycaemia glucose\u00a0:\u00a0creatine ratios decreased in both groups (CON 0\u00b707\u00a0\u00b1\u00a00\u00b708, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705; T1DM 0\u00b703\u00a0\u00b1\u00a00\u00b703, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). A significant drop in the glutamate\u00a0:\u00a0creatine ratio could only be found in CON during hypoglycaemia (CON 1\u00b736\u00a0\u00b1\u00a00\u00b708 vs. 1\u00b726\u00a0\u00b1\u00a00\u00b711; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701; T1DM 1\u00b732\u00a0\u00b1\u00a00\u00b713 vs. 1\u00b728\u00a0\u00b1\u00a00\u00b715; <jats:italic>P<\/jats:italic>\u00a0=\u00a0NS). The ratios of glutamine, N\u2010acetylaspartate, choline and myo\u2010inositol\u00a0:\u00a0creatine were not different between both groups and did not change throughout the experiment.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Only in CON does moderate hypoglycaemia reduce intracerebral glutamate concentrations, possibly owing to a slower substrate flux through the tricarboxylic acid cycle in neurones. The maintenance of normal energy metabolism in T1DM during hypoglycaemia might effect glucose sensing in the brain and contribute to hypoglycaemia\u2010associated autonomic failure.<\/jats:p>","DOI":"10.1111\/j.1365-2362.2006.01615.x","type":"journal-article","created":{"date-parts":[[2006,2,27]],"date-time":"2006-02-27T11:13:45Z","timestamp":1141038825000},"page":"164-169","source":"Crossref","is-referenced-by-count":19,"title":["Cerebral glutamate metabolism during hypoglycaemia in healthy and type 1 diabetic humans"],"prefix":"10.1111","volume":"36","author":[{"given":"M. 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