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Brain control of blood glucose levels: implications for the pathogenesis of type 2 diabetes – published online 12/10/2020

Alonge GA

Kimberly M. Alonge, David A.  D’Alessio, Michael W. Schwartz

In this issue, Alonge and colleagues ( present a framework for understanding the brain’s role in glucose homeostasis. Their review outlines a crucial role for the brain in sensing blood glucose levels and they cite evidence in support of the concept that defects in this process are fundamental to the pathogenesis of type 2 diabetes. This framework also proposes that the close association between obesity and type 2 diabetes arises from a shared defect in overlapping and highly integrated brain neurocircuitry governing energy homeostasis and glucose homeostasis. The authors highlight the translational potential of this framework by summarising evidence that, in preclinical models of type 2 diabetes, blood glucose levels can be restored to normal in a sustained manner by therapies targeting the brain. They conclude that these considerations suggest that, unlike current non-surgical treatment options, strategies targeting the brain have the potential to induce sustained remission of type 2 diabetes. The figures from this review are available as a downloadable slideset.

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