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Submited on: 08 Nov 2010 11:16:49 AM GMT
Published on: 08 Nov 2010 10:15:25 PM GMT
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I have mentioned in this hypothesis ‘As the hyperactive Vagus tends to cause hypoglycemia, the bodily equilibrium is adjusted so that the glucose is maintained at higher levels’. I have also observed that the elevated blood sugar levels of the patients came down with the anticholinergic Hyoscine.
This hypothesis is three decades old but newer evidences, involving GIP and GLP-1, support it. Gastric inhibitory polypeptide (GIP) along with glucagon-like peptide-1 (GLP-1) belongs to a class of hormones referred to as Incretins that lower blood sugar levels.
The findings of a study (1) demonstrating a stimulatory role for the Vagus nerve in secretion of GLP-1 and another report (2) mentioning cholinergic fibres having positive effects on Incretin secretion, supports our hypothesis that ‘hyperactive Vagus tends to cause hypoglycemia’.
In another study (3) the authors conclude: suppression of Vagally mediated GLP-1, GIP secretion alone by Hyoscine cannot explain the blood glucose profile, which would then be expected to be higher, rather than lower and overall blood glucose concentrations were lower with Hyoscine infusion. This explains the ‘paradox’ of our ‘hypothesis’ and also supports the observation that elevated blood sugar levels of patients came down with drugs containing Hyoscine .
References
1. Role of the Vagus Nerve in Mediating Proximal Nutrient-Induced Glucagon-Like Peptide-1 Secretion. A. S. Rocca , P. L. Brubaker. Endocrinology 1999 140: 1687-1694; doi:10.1210/en.140.4.1687.
2. What do we know about the secretion and degradation of incretin hormones? Deacon, CF. Regulatory Peptides, Volume: 128 Issue: 2 Pages: 117-124 DOI:10.1016/j.regpep.2004.06.007
3. Concurrent duodenal manometric and impedance recording to evaluate the effects of hyoscine on motility and flow events, glucose absorption, and incretin release. Chaikomin R, Wu KL, Doran S, Jones KL, Smout AJ, Renooij W, Holloway RH, Meyer JH, Horowitz M, Rayner CK. Am J Physiol Gastrointest Liver Physiol. 2007 Apr;292(4):G1099-104. Epub 2007 Jan 4.