Hormonal
The central nervous system (CNS) acts as a fundamental regulator of glucose homeostasis by establishing a biologically defended level of glycemia (BDLG), and dysfunction in CNS control mechanisms contributes to the pathogenesis of type 2 diabetes (T2D) independently of pancreatic beta cell failure.
Current diabetes treatments often fail to achieve long-term remission because they only address insulin levels, ignoring the brain's role in setting a 'defended' high blood sugar level. Effective management may require strategies that address central nervous system regulation of glucose, not just pancreatic insulin output.
Based on evidence supporting its role both in adaptive coupling of insulin secretion to changes in insulin sensitivity and in the regulation of insulin-independent glucose disposal, the central nervous system (CNS) has emerged as a fundamental player in glucose homeostasis.
Why this rating
The paper is a comprehensive review citing multiple prospective cohort studies, animal models, and clinical observations, though it is not a single primary RCT.
Source
Central Nervous System Control of Glucose Homeostasis: A Therapeutic Target for Type 2 Diabetes?
Zaman Mirzadeh et al. · The Annual Review of Pharmacology and Toxicology · 2022
DOI 10.1146/annurev-pharmtox-052220-010446
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