Antecedent hypoglycaemia impairs glucagon secretion by enhancing somatostatin-mediated negative feedback control.

Gao R., Acreman S., Dou H., Ma J., Miranda C., Zhao R., Dickerson MT., Tarasov A., Zou Q., Gironella-Torrent M., Tolö J., Clark A., Gao R., De Marinis Y., Jacobson DA., Camunas-Soler J., Yang T., Rorsman P., Zhang Q.

Somatostatin, produced by pancreatic islet δ cells, is a key intra-islet paracrine factor that regulates the secretion of the glucoregulatory hormones insulin and glucagon from β cells and α cells, respectively. Here, we show that glutamate and glucagon released by α cells cooperatively activate neighbouring δ cells through AMPA and glucagon receptors, thereby enabling spatiotemporal feedback control of glucagon secretion. Crucially, prior hypoglycaemia enhances this mechanism by sensitizing δ cells to α cell-derived factors and inducing long-lasting structural and functional changes that facilitate δ cell and α cell paracrine interaction. This culminates in somatostatin hypersecretion that impairs counter-regulatory glucagon release. These hypoglycaemia-driven effects were emulated by chemogenetic activation of α cells or high concentrations of exogenous glucagon but prevented by inhibitors of glucagon receptors or the transcription factor CREB. This plasticity represents a key component of the islet's 'metabolic memory', which, through impaired counter-regulatory glucagon secretion, increases the occurrence of recurrent hypoglycaemia that complicates the management of insulin-dependent diabetes.

DOI

10.1038/s42255-025-01422-7

Type

Journal article

Publication Date

2026-01-01T00:00:00+00:00

Volume

8

Pages

159 - 176

Total pages

17

Addresses

Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.

Keywords

Animals, Mice, Hypoglycemia, Somatostatin, Glucagon, Insulin, Glutamic Acid, Receptors, Glucagon, Somatostatin-Secreting Cells, Glucagon-Secreting Cells, Feedback, Physiological

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