Peripheral nerve-mediated glucose lowering: Mechanisms, translational strategies, and future perspectives

Table 2 Overview of the neural regulation of glucose metabolism

Component	Description	Key structures/examples	Primary function	Ref.
Sensors	Sensory nerve endings acting as chemoreceptors and mechanoreceptors	Portal vein, liver, intestine, pancreas	Monitor blood glucose, nutrients, hormones, and metabolites	Joly-Amado et al[15], 2022
Afferent pathway	Nerves transmitting sensory signals to the central nervous system	Vagal afferent nerves (via nodose ganglion), spinal afferent nerves	Encode and relay peripheral signals to the brainstem (NTS)	Li et al[16], 2023
Central integration	Brain regions that process sensory information and generate commands	NTS, hypothalamus (ARC, PVN, VMH), parabrachial nucleus, cortex	Integrate signals to regulate energy balance and generate sensations like hunger	Vohra et al[17], 2022
Efferent pathway	Nerves conveying commands from the brain to peripheral organs	Sympathetic pathways, Parasympathetic pathways (dorsal vagal complex)	Regulate insulin secretion, glucose production/uptake, and gastrointestinal function to restore homeostasis	Papazoglou et al[18], 2022

NTS: Nucleus tractus solitarius; ARC: Arcuate nucleus; PVN: Paraventricular nucleus; VMH: Ventromedial hypothalamus.