Effect of lactate administration on cerebral blood flow during hypoglycemia in people with type 1 diabetes

Figures

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  Figure 1. (A) Schematic overview of the study protocol, (B) Arterial glucose levels during lactate infusion (red circles) and placebo infusion (black circles) and (C) arterial lactate levels during lactate infusion (red circles) and placebo infusion (black circles). CBF, cerebral blood flow.

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  Figure 2. Counter-regulatory hormone levels at baseline (Bsl), during euglycemia (Eu) and during hypoglycemia, with lactate infusion (red) and placebo infusion (black), *p<0.05.

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  Figure 3. (A) Change in global cerebral blood flow (CBF) from baseline during lactate infusion (red circles) and placebo infusion (black circles). Bsl=baseline measurement; mean CBF value of three euglycemic CBF measurements without lactate/placebo infusion. (B) Quantitative CBF maps averaged over all subjects with type 1 diabetes mellitus and normal awareness of hypoglycemia during euglycemic and hypoglycemic state and during infusion of lactate and placebo. CBF values are color coded with the Flow(Brain colors) (iso) lookup table and range from 1 to 100 mL/100 g tissue/min.

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  Figure 4. Redistribution of cerebral blood flow (CBF) in response to hypoglycemia by type of infusion in subjects with type 1 diabetes mellitus and normal awareness of hypoglycemia. Z-scores of infusion-induced significant changes (p<0.05) in regional CBF are superimposed on the axial and sagittal views of the MNI-152 atlas and indicate a significant increase (red to yellow, 2 to 5 times SD) or decrease (dark to light blue, −2 to −5 times SD) in regional CBF in lactate relative to placebo infusion. The white underlay indicates the thalamus, and the black arrows point to the cingulate gyrus.