High-Calorie Glucose-Rich Food Attenuates Neuroglycopenic Symptoms in Patients with Addison’s Disease

Klement, Johanna; Hubold, Christian; Cords, Hannah; Oltmanns, Kerstin M.; Hallschmid, Manfred; Born, Jan; Lehnert, Hendrik; Peters, Achim

doi:10.1210/jc.2009-1752

Cited by 26 publications

(23 citation statements)

References 31 publications

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“…Therefore, the obesogenic environment of modern humans has led to, among other things, an internal condition with impaired capability to allocate energy from alternative fuel sources other than glucose, especially for the needs of neurons. This is due to the fact that these alternative energy systems are rarely, if ever, required to be the dominant source of energy provisions [47,48]. In affluent societies, food is not only consumed in order to maintain energy balance but also for hedonic attributes independent of energy status, and this might be one of the reasons for calorie excess [49,50].…”

Section: Discussionmentioning

confidence: 99%

Back to the Future. Metabolic Effects of a 4-Day Outdoor Trip Under Simulated Paleolithic Conditions – New Insights from The Eifel Study

Freese¹

2013

jevohealth

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Background: The observation that the emergence of common Western diseases takes place with much greater prevalence as societies migrate from natural-living cultures to modernized societies, has been well documented. For approximately 84,000 generations humans lived under hunter-gatherer conditions but recently endured dramatic change from our native lifestyle with the occurrence of the agricultural, industrial, and digital revolutions. The massive technological advancement that occurred within a relatively recent timeframe enabled humans to live in manner that is remarkably different than our pre-agricultural past. Consequently, the shift from a natural to a modern lifestyle likely promotes a gene-environment mismatch which causes metabolic dysregulation which causes disease.

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Section: Discussionmentioning

confidence: 99%

Back to the Future. Metabolic Effects of a 4-Day Outdoor Trip Under Simulated Paleolithic Conditions – New Insights from The Eifel Study

Freese¹

2013

jevohealth

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“…Proper functioning of SNS and HPA-axis is indispensable for maintaining cerebral functioning and cerebral energy concentrations when food availability is low (Klement et al, 2010;Peters and Langemann, 2009). When food availability is high, however, a limited SNS and HPA axis effectivity can be compensated for by an increased body-pull (Klement et al, 2010;Peters and Langemann, 2009). In detail: With blunted brain-pull reactivity, the 'percentage-of-glucose-allocated-to-the brain' decreases.…”

Section: Body Mass Gainmentioning

confidence: 99%

Stress habituation, body shape and cardiovascular mortality

Peters

McEwen

2015

Neuroscience & Biobehavioral Reviews

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112

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High cardiovascular mortality is well documented in lean phenotypes exhibiting visceral fat accumulation. In contrast, corpulent phenotypes with predominantly subcutaneous fat accumulation display a surprisingly low mortality. The term 'obesity paradox' reflects the difficulty in understanding the biological mechanisms underlying these clinical observations. The allostatic load model of chronic stress focuses on glucocorticoid dysregulation as part of a 'network of allostasis' involving autonomic, endocrine, metabolic, and immune mediators. Here, we expand upon the energetic demands of the brain and show that 'habituators' and 'non-habituators' develop divergent patterns of fat distribution. Central to this process is the recurrent rise in the cerebral energy need (arousal) that non-habituators experience during chronic stress. These neuroenergetic alterations promote visceral fat accumulation, subcutaneous fat loss, and atherogenesis with subsequent cardiovascular events. Habituators are more or less protected against such cardiovascular complications, but there is a metabolic trade-off that we shall discuss in the present paper.

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“…Patients with Addison's disease often suffer from symptoms reminiscent of neuroglycopenia, suggesting that this disorder is associated with a deficit in cerebral energy supply. 2 However, there are few data about hypoglycemia, particularly nocturnal, in patients with Addisons's disease.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal Hypoglycemia Identified by a Continuous Glucose Monitoring System in Patients with Primary Adrenal Insufficiency (Addison's Disease)

Meyer

Hackemann

Reusch

et al. 2012

Diabetes Technology & Therapeutics

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Background: Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Methods: Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days.Results: In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Conclusions: Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

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High-Calorie Glucose-Rich Food Attenuates Neuroglycopenic Symptoms in Patients with Addison’s Disease

Cited by 26 publications

References 31 publications

Back to the Future. Metabolic Effects of a 4-Day Outdoor Trip Under Simulated Paleolithic Conditions – New Insights from The Eifel Study

Back to the Future. Metabolic Effects of a 4-Day Outdoor Trip Under Simulated Paleolithic Conditions – New Insights from The Eifel Study

Stress habituation, body shape and cardiovascular mortality

Nocturnal Hypoglycemia Identified by a Continuous Glucose Monitoring System in Patients with Primary Adrenal Insufficiency (Addison's Disease)

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