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Saturday, March 25, 2023

Hypoglycemia worsens ocular pathology in people with diabetes

People with diabetes who experience episodes of low blood sugar levels are more likely to develop a diabetic eye condition. Diabetic retinopathy, which occurs in up to one third of people with diabetes, is characterized by excessive growth of blood vessels in …

People with diabetes who experience episodes of low blood sugar are more likely to have Diabetic Pathology bad condition. Diabetic retinopathy, which occurs in up to one third of people with diabetes, is characterized by CRexcessive growth of blood vessels on the retina

In this context, a study conducted by the Johns Hopkins School of Medicine (USA) linked low blood sugar levels with a. molecular pathway that is activated In those cells of the eye that lack oxygen.

loss temporary episodes of low glucose They can occur once or twice a day in people with insulin-dependent diabetes and are more frequent in people who are recently diagnosed with the condition. They can also occur during sleep in people with non-insulin-dependent diabetes.

,Our results suggest that these periodic low glucose levels cause an increase in certain proteins in retinal cells, which, in turn, lead to excessive blood vessel growth and worsening of diabetic eye disease.“, as explained dr. The Branna and Irving Sisenwein Professor of Ophthalmology at the Wilmer Eye Institute at Johns Hopkins Medicine.

For the study, published in Cell Reports, the researchers analyzed the levels of the protein in mouse and human retinal cells and intact retinas grown in low-glucose environments in the laboratory, as well as in mice that occasionally had low glucose levels. was less blood.

cascade of molecular changes

The research team found that low glucose levels in mouse and human retinal cells a cascade of molecular changes This can lead to overgrowth of blood vessels. First, they found that the low glucose caused a decrease in the retinal cells’ ability to break down glucose for energy.

When the researchers looked at so-called Müller glial cells, which are support cells for neurons in the retina and rely primarily on glucose for energy production, they found that the cells increased expression of the GLUT1 gene, which is a protein produces glucose that transports glucose to the body. cells.

They were also able to verify that in response to low glucose, the cells increased levels of a transcription factor called hypoxia-inducible factor (HIF)-1α. This turned on cellular machinery, including GLUT1, which is needed to increase its ability to use available glucose, preserving the limited oxygen available for energy production by retinal neurons.

However, in low-oxygen environments, such as in the retina of patients with diabetic eye disease, this normal physiological response to low glucose triggers an influx of HIF-1α protein into the nucleus of cells, the control center for blood glucose. This increased production of proteins such as VEGF and ANGPTL4, which cause the growth of abnormal and leaky blood vessels, the main cause of vision loss in people with diabetic eye disease.

The researchers plan to study whether Low glucose levels in people with diabetes may affect other molecular pathways Similar in other organs like kidney and brain. ,The HIF-1α pathway may serve as an effective target for developing new treatments for diabetic eye disease.” Dr. Sodhi concluded.

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