The Vagus Nerve and Diabetes: How the Brain Affects Glucose Levels

Today we will be discussing how the brain’s modulation of the vagus nerve affects glucose levels.  Frequently we discuss the two sides of the autonomic nervous system which for all intents and purposes involve rest and digest responses juxtaposed with fight and flight reactions.  While the majority of discussions surrounding diabetes involve insulin resistance at the level of the liver or skeletal muscle, today we will highlight how insulin resistance is being observed in the brain, how this affects diabetes, as well as novel treatments designed to increase vagal nerve tone for the treatment of diabetes. .

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1.Obesity-Associated Alterations in Glucose Metabolism Are Reversed by Chronic Bilateral Stimulation of the Abdominal Vagus Nerve.
Malbert CH, Picq C, Divoux JL, Henry C, Horowitz M.
Diabetes. 2017 Apr;66(4):848-857. doi: 10.2337/db16-0847. Epub 2017 Jan 12.
PMID: 28082456 [PubMed – in process]
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2.Effects of hepatic glycogen on food intake and glucose homeostasis are mediated by the vagus nerve in mice.
López-Soldado I, Fuentes-Romero R, Duran J, Guinovart JJ.
Diabetologia. 2017 Jun;60(6):1076-1083. doi: 10.1007/s00125-017-4240-4. Epub 2017 Mar 15.
PMID: 28299379 [PubMed – in process]
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3.Hepatic vagus nerve regulates Kupffer cell activation via ?7 nicotinic acetylcholine receptor in nonalcoholic steatohepatitis.
Nishio T, Taura K, Iwaisako K, Koyama Y, Tanabe K, Yamamoto G, Okuda Y, Ikeno Y, Yoshino K, Kasai Y, Okuno M, Seo S, Sakurai T, Asagiri M, Hatano E, Uemoto S.
J Gastroenterol. 2017 Jan 2. doi: 10.1007/s00535-016-1304-z. [Epub ahead of print]
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4.Knockdown of Neuropeptide Y in the Dorsomedial Hypothalamus Promotes Hepatic Insulin Sensitivity in Male Rats.
Li L, de La Serre CB, Zhang N, Yang L, Li H, Bi S.
Endocrinology. 2016 Dec;157(12):4842-4852. Epub 2016 Nov 2.
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5.Central administration of vaspin inhibits glucose production and augments hepatic insulin signaling in high-fat-diet-fed rat.
Luo X, Li K, Zhang C, Yang G, Yang M, Jia Y, Zhang L, Ma ZA, Boden G, Li L.
Int J Obes (Lond). 2016 Jun;40(6):947-54. doi: 10.1038/ijo.2016.24. Epub 2016 Feb 12.
PMID: 26975443 [PubMed – in process]
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6.Contrasting effects of afferent and efferent vagal nerve stimulation on insulin secretion and blood glucose regulation.
Meyers EE, Kronemberger A, Lira V, Rahmouni K, Stauss HM.
Physiol Rep. 2016 Feb;4(4). pii: e12718. doi: 10.14814/phy2.12718.
PMID: 26884478 [PubMed – indexed for MEDLINE] Free PMC Article
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7.A fatty acid-dependent hypothalamic-DVC neurocircuitry that regulates hepatic secretion of triglyceride-rich lipoproteins.
Yue JT, Abraham MA, LaPierre MP, Mighiu PI, Light PE, Filippi BM, Lam TK.
Nat Commun. 2015 Jan 12;6:5970. doi: 10.1038/ncomms6970.
PMID: 25580573 [PubMed – indexed for MEDLINE]
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8.Insulin action in the hypothalamus and dorsal vagal complex.
Abraham MA, Filippi BM, Kang GM, Kim MS, Lam TK.
Exp Physiol. 2014 Sep;99(9):1104-9. doi: 10.1113/expphysiol.2014.079962. Epub 2014 Jun 27. Review.
PMID: 24972836 [PubMed – indexed for MEDLINE] Free Article
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9.Risk of postprandial insulin resistance: the liver/vagus rapport.
Macedo MP, Lima IS, Gaspar JM, Afonso RA, Patarrão RS, Kim YB, Ribeiro RT.
Rev Endocr Metab Disord. 2014 Mar;15(1):67-77. doi: 10.1007/s11154-013-9281-5. Review.
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10.Glycogen shortage during fasting triggers liver-brain-adipose neurocircuitry to facilitate fat utilization.
Izumida Y, Yahagi N, Takeuchi Y, Nishi M, Shikama A, Takarada A, Masuda Y, Kubota M, Matsuzaka T, Nakagawa Y, Iizuka Y, Itaka K, Kataoka K, Shioda S, Niijima A, Yamada T, Katagiri H, Nagai R, Yamada N, Kadowaki T, Shimano H.
Nat Commun. 2013;4:2316. doi: 10.1038/ncomms3316. Erratum in: Nat Commun. 2013;4:2930.
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One Comment


    This conversation is very interesting. I’m a doctor, and intend to study the auricular vagus nerve stimulation and take thermographic images of the feet of diabetic patients, hoping to find a rise in temperature due to the release of nitric oxide. Thanks for your valuable information.

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