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Publication : HIF-1α accumulation in response to transient hypoglycemia may worsen diabetic eye disease.

First Author  Guo C Year  2023
Journal  Cell Rep Volume  42
Issue  1 Pages  111976
PubMed ID  36640318 Mgi Jnum  J:332902
Mgi Id  MGI:7430622 Doi  10.1016/j.celrep.2022.111976
Citation  Guo C, et al. (2023) HIF-1alpha accumulation in response to transient hypoglycemia may worsen diabetic eye disease. Cell Rep 42(1):111976
abstractText  Tight glycemic control (TGC), the cornerstone of diabetic management, reduces the incidence and progression of diabetic microvascular disease. However, TGC can also lead to transient episodes of hypoglycemia, which have been associated with adverse outcomes in patients with diabetes. Here, we demonstrate that low glucose levels result in hypoxia-inducible factor (HIF)-1-dependent expression of the glucose transporter, Glut1, in retinal cells. Enhanced nuclear accumulation of HIF-1alpha was independent of its canonical post-translational stabilization but instead dependent on stimulation of its translation and nuclear localization. In the presence of hypoxia, this physiologic response to low glucose resulted in a marked increase in the secretion of the HIF-dependent vasoactive mediators that promote diabetic retinopathy. Our results provide a molecular explanation for how early glucose control, as well as glycemic variability (i.e., oscillating serum glucose levels), contributes to diabetic eye disease. These observations have important implications for optimizing glucose management in patients with diabetes.
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