We sought to elucidate the role of the portal vein a fferents in the sympathetic response to hypoglycemia. Laparotomy was performed on 27 male Wi s t a r rats. Portal veins were painted with either 90% phenol (denervation group [PDN]) or 0.9% saline solution (sham-operated group [SHAM]). Rats were chronically cannulated in the carotid artery (sampling), jugular vein (infusion), and portal vein (infusion). After a recovery period of 5 days, animals were exposed to a hyperinsulinemic-hypoglycemic clamp, with glucose infused either portally (POR) or peripherally (PER). In all animals, systemic hypoglycemia (2.48 ± 0 . 0 9 mmol/l) was induced via jugular vein insulin infusion (50 mU · k g -1 · min -1 ). Arterial plasma catecholamines were assessed at basal (-30 and 0 m i n ) and during sustained hypoglycemia (60, 75, 90, and 105 min). By design, portal vein glucose concentrations were significantly elevated during POR versus PER (4.4 ± 0.14 vs. 2.5 ± 0.07 mmol/l; P < 0.01, respectively) for both PDN and SHAM. There were no significant differences in arterial glucose or insulin concentration between the four experimental conditions at any point in time. When portal glycemia and systemic glycemia fell concomitantly (SHAM-PER), epinephrine increased 12-fold above basal (3.75 ± 0.34 and 44.56 ± 6.1 nmol/l; P < 0.001). However, maintenance of portal normoglycemia (SHAM-POR) caused a 50% suppression of the epinephrine response, despite cerebral hypoglycemia (22.2 ± 3.1 nmol/l, P < 0.001). Portal denervation resulted in a significant blunting of the sympathoadrenal response to whole-body hypoglycemia (PDN-PER 27.6 ± 3.8 nmol/l vs. SHAM-PER; P < 0.002). In contrast to the sham experiments, there was no further suppression in arterial epinephrine concentrations observed during PDN-POR versus PDN-PER (P = 0.8). These findings indicate that portal vein afferent innervation is critical for hypoglycemic detection and normal sympathoadrenal counterregulation. D i a b e t e s 4 9 :8-12, 2000 C atecholamines constitute the primary defense against hypoglycemia for individuals with type 1 diabetes, in which the ability to suppress insulin is absent and the capacity to secrete glucagon is diminished. The catecholamine response has been well characterized for both normal and diabetic individuals (1-4). Under normal conditions, this sympathetic response appears sufficient to compensate for the loss of other counterregulatory measures (1,2). Unfortunately, over time, the catecholamine response for individuals with type 1 diabetes diminishes relative to the fall in blood glucose (1,2). The diminished catecholamine response appears to have been further exacerbated by increasingly aggressive attempts to control blood glucose levels in type 1 diabetic patients (3,4).Although iatrogenic hypoglycemia has been invoked as a partial explanation, in general, the pathology of the diminished sympathetic response in patients with type 1 diabetes remains poorly understood. In part, this can be attributed to the lack of knowledge concerning the locus f...