This issue covers an emerging issue, namely, the central control of metabolism. Until recently, it was believed that control of peripheral metabolism was that peripheral tissue's response to nutrients and hormonal control was directly on the tissue itself, and only appetite and satiety were controlled by the hypothalamus. We now have evidence to the contrary; control of peripheral metabolism is both central and peripheral. As described by Drs Osundiji and Evans, pancreatic release of insulin and glucagon is regulated at the local level as well as centrally. They describe many of these central control mechanisms, including direct autonomic neural efferents, both sympathetic and parasympathetic, and detail the nuclei in the brain that control these pathways. They further describe the effect of glucose and lipids on the hypothalamic control of pancreatic hormone release as well as central GLP-1 effects, the role of the melano-cortin system. Finally, in regard to hypothalamic effects of glucagon release secondary to hypoglycemia, there are a number of mechanisms being researched including K/ATP channels, AMPK activity, and glucose transport changes.
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