Diabetes.: auth.: group Thorens

Diabetes. 2021 Apr 21;db201121. doi: 10.2337/db20-1121. Online ahead of print.

Fgf15 neurons of the dorsomedial hypothalamus control glucagon secretion and hepatic gluconeogenesis

Alexandre Picard 1Salima Metref 1David Tarussio 1Wanda Dolci 1Xavier Berney 1Sophie Croizier 1Gwenaël Labouebe 1Bernard Thorens 2


The counterregulatory response to hypoglycemia is an essential survival function. It is controlled by an integrated network of glucose responsive neurons, which trigger endogenous glucose production to restore normoglycemia. The complexity of this gluco-regulatory network is, however, only partly characterized. In a genetic screen of a panel of recombinant inbred mice we previously identified Fgf15, expressed in neurons of the dorsomedial hypothalamus, as a negative regulator of glucagon secretion. Here, we report on the generation of Fgf15CretdTomato mice and their use to further characterize these neurons. We showed that they were glutamatergic and comprised glucose inhibited and glucose excited neurons. When activated by chemogenetics, Fgf15 neurons prevented the increase in vagal nerve firing and the secretion of glucagon normally triggered by insulin-induced hypoglycemia. On the other hand, they increased the activity of the sympathetic nerve in the basal state and prevented its silencing by glucose overload. Higher sympathetic tone increased hepatic Creb1 phosphorylation, Pck1 mRNA expression, and hepatic glucose production leading to glucose intolerance. Thus, Fgf15 neurons of the dorsomedial hypothalamus participate in the counterregulatory response to hypoglycemia by a direct adrenergic stimulation of hepatic glucose production while suppressing vagally-induced glucagon secretion. This study provides new insights into the complex neuronal network that prevents the development of hypoglycemia.