FIGURE 11.

Possible process of NTS participating in blood glucose homeostasis. With increased blood sugar, the ability of islet beta cells to secrete insulin is enhanced. Insulin acts on its receptors to increase the efficiency of glucose transport into the cell, and blood glucose level decrease. The above mechanism (shown in black) does not involve the central nervous system. The regulation of blood glucose homeostasis by NTS is presented in blue. If the NTS feels that the blood glucose concentration rises, it may reduce the intensity of glucagon secretion by the islet alpha cells through the parasympathetic neural circuit (not completely clear, with question marks), and it can also send signals to the hypothalamus, reducing the excitability of the HPA axis and the release of glucocorticoids. Therefore, NTS may be the hub of a larger negative feedback regulation loop that compensates for the small loop of insulin regulation. If the NTS is damaged by the CRS, the insulin regulation mechanism is still intact, but the ability of regulation is limited.