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Table 1 Central mechanisms involved in glucose homeostasis and benefit of modulating them for diabetes management

From: Review of the role of the nervous system in glucose homoeostasis and future perspectives towards the management of diabetes

Region Population of neurons Peripheral mechanisms Impact on glucose homeostasis Ref. Opportunities for diabetes management
ARC AgRP Food entrained oscillator Regulate feeding behaviour (Stephan et al. 1979) Predicting cephalic phase
  AgRPaBNST6vl BAT myostatin expression Insulin resistance (Steculorum et al.2016) Control of SI
  ARCAgRPLHN Appetite G(t) (Steculorum et al.2016) Control of food intake
  AgRPIR Hepatic vagal tone HGP Peripheral glucose uptake (Shin et al. 2017; Yi et al. 2010; Scherer et al. 2011) Control of hepatic SI
  NPY Appetite G(t) (Billington and Levine 1992) Control of food intake
   Hepatic sympathetic tone HGP (Yi et al. 2010) Control of hepatic SI
  NPYPVNTH Sympathetic tone BAT thermogenesis (Yi et al. 2010; Shi et al. 2013) -
  POMC Sympathetic tone WAT lypolisis (Shin et al. 2017; Brito et al. 2007) -
   MC4R mutations Insulin resistance (Elmquist and Marcus 2003) Control of SI
  P O M C IR Impaired insulin action WAT lipolysis (Shin et al. 2017) Control of SI
  TH Appetite G(t) (Zhang and van den Pol 2016) Control of food intake
VMH V M H SF1 - Glucose uptake HGP (Coutinho et al. 2017) Control of hepatic SI
   Glucagon Insulin G(t) (Shimazu and Ishikawa 1981; Stanley et al.2016; Shimazu and Ishikawa 1981) Control of hypoglycemia
  V M H Glut Sympathetic tone HGP Tissue uptake (Shimazu et al. 1966; Gellman et al. 1981; Coutinho et al. 2017) Control of blood glucose levels
   Glutamatergic metabolism Response to hypoglycemia (Chowdhury et al.2017) Control of hypoglycemia
LHN LHN Parasympathetic tone HGP (Shimazu et al. 1991) Control of blood glucose levels
  L H N MC4 R Sympathetic tone BAT glucose uptake (Morgan et al. 2015) Control of SI
SCN SCNPVN Sympathetic tone HGP (Fujii et al. 1989; Kalsbeek et al. 2004) Control of hepatic SI
  1. This table summarizes the impact of activating the most relevant brain regions involved in glucose homeostasis and the potential benefit of changing their activity for modulating insulin sensitivity (SI) and food intake in the context of type 1 and type 2 diabetes management. In particular, their effect on plasma glucose levels (G(t)), hepatic glucose production (HGP) and glucose uptake is shown