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 glucoregulatory 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 (DMH), as a negative regulator of glucagon secretion. Here, we report on the generation of Fgf15 CretdTomato mice and their use to further characterize these neurons. We show 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 DMH 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.The central nervous system controls multiple aspects of glucose homeostasis including pancreatic islet hormone secretion and hepatic glucose production as well as glucose utilization by muscle and fat. The connection between the brain and these peripheral tissues is ensured, in large part, by the autonomic nervous system. This is activated in response to changes in the concentration of circulating hormones such as insulin, leptin, or ghrelin and of nutrients such as glucose and lipids. Glucose-responsive neurons, which increase their firing activity in response to hyperglycemia (glucose-excited [GE] neurons) or to hypoglycemia (glucose-inhibited [GI] neurons) (1-3), are thought to couple fluctuations in blood glucose concentrations to the regulation of sympathetic or parasympathetic nerve activity.A major glucoregulatory role of the central nervous system is to maintain glycemic levels at a minimum value of $5 mmol/L to preserve sufficient glucose provision to the brain. Hypoglycemia does not usually occur in healthy subjects because of the rapid secretion of the counterregulatory hormones glucagon, epinephrine, norepinephrine, cortisol, and growth hormones when blood glucose concentrations fall below the euglycemic level (4,5). However, in insulin-treated patients with type 1 or type 2 diabetes, this counterregulatory response becomes blunted, leading to hypoglycemic episodes of progressively increased severity; this condition represents a major limitation in the insulin treatment of diabetes (6-8). The cellular and molecular basis ...