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To investigate the role of the brain in this coupling process, we used cold exposure as an experimental paradigm because the sympathetic nervous system (SNS) helps to coordinate the major shifts of tissue glucose utilization needed to ensure that increased thermogenic needs are met. We found that glucose-induced insulin secretion declined by 50% in rats housed at 5\u00b0C for 28 h, and yet, glucose tolerance did not change, owing to a doubling of insulin sensitivity. These potent effects on insulin secretion and sensitivity were fully reversed by returning animals to room temperature (22\u00b0C) for 4 h or by intravenous infusion of the \u03b1-adrenergic receptor antagonist phentolamine for only 30 min. By comparison, insulin clearance was not affected by cold exposure or phentolamine infusion. These findings offer direct evidence of a key role for the brain, acting via the SNS, in the rapid, highly coordinated, and reciprocal changes of insulin secretion and insulin sensitivity that preserve glucose homeostasis in the setting of cold exposure.<\/jats:p>","DOI":"10.2337\/db16-1351","type":"journal-article","created":{"date-parts":[[2017,1,23]],"date-time":"2017-01-23T21:15:10Z","timestamp":1485206110000},"page":"823-834","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":54,"title":["Evidence That the Sympathetic Nervous System Elicits Rapid, Coordinated, and Reciprocal Adjustments of Insulin Secretion and Insulin Sensitivity During Cold Exposure"],"prefix":"10.2337","volume":"66","author":[{"given":"Gregory J.","family":"Morton","sequence":"first","affiliation":[{"name":"University of Washington Diabetes Institute, Department of Medicine, University of Washington, Seattle, 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