{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:58:49Z","timestamp":1761893929095},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2004,3,26]],"date-time":"2004-03-26T00:00:00Z","timestamp":1080259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aim\u2003<\/jats:bold>To investigate the potential for the non\u2010glucose metabolic substrate alanine to support brain function during glucose deprivation in man.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold>Seven healthy men were studied on two occasions using a hyperinsulinaemic glucose clamp to lower arterialized plasma glucose to 2.5\u00a0mmol\/l, in the presence of either 2\u00a0mmol\/kg\/h alanine infusion or saline, measuring counter\u2010regulatory hormonal responses, symptoms generated and cognitive function with a mini\u2010battery of tests sensitive to hypoglycaemia.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold>Alanine infusion elevated plasma alanine (peak value 1481\u00a0\u00b1\u00a01260 vs. 138\u00a0\u00b1\u00a032 \u00b5mol\/l,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02 alanine vs. saline) and lactate (peak value 3.09\u00a0\u00b1\u00a00.14 vs. 2.05\u00a0\u00b1 0.12\u00a0mmol\/l,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Cognitive function assessed by the Stroop word and colour subtests deteriorated less with alanine than saline (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01 for both). Other cognitive function tests deteriorated equally and counter\u2010regulatory hormones rose equally during hypoglycaemia in both studies (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.34) except for increased glucagon with alanine (peak 260\u00a0\u00b1\u00a053 vs. 91\u00a0+\u00a08\u00a0ng\/l,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). There was no significant effect of alanine on either autonomic or neuroglycopenic symptom scores.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold>Some, but not all, aspects of cognitive performance may be supported by an alanine infusion during hypoglycaemia. It is not clear whether alanine supports brain function directly or via increased availability of lactate. These data contribute to the growing evidence that regional metabolic differences exist in the brain's ability to use non\u2010glucose fuels during hypoglycaemia.<\/jats:p><jats:p>Diabet. Med. (2004)<\/jats:p>","DOI":"10.1111\/j.1464-5491.2004.01174.x","type":"journal-article","created":{"date-parts":[[2004,4,16]],"date-time":"2004-04-16T08:22:32Z","timestamp":1082103752000},"page":"440-446","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Alanine infusion during hypoglycaemia partly supports cognitive performance in healthy human subjects"],"prefix":"10.1111","volume":"21","author":[{"given":"M. L.","family":"Evans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Hopkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. 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