2015
DOI: 10.1016/j.cmet.2015.07.003
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Glucoregulatory Relevance of Small Intestinal Nutrient Sensing in Physiology, Bariatric Surgery, and Pharmacology

Abstract: Emerging evidence suggests the gastrointestinal tract plays an important glucoregulatory role. In this perspective, we first review how the intestine senses ingested nutrients, initiating crucial negative feedback mechanisms through a gut-brain neuronal axis to regulate glycemia, mainly via reduction in hepatic glucose production. We then highlight how intestinal energy sensory mechanisms are responsible for the glucose-lowering effects of bariatric surgery, specifically duodenal-jejunal bypass, and the antidi… Show more

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Cited by 53 publications
(39 citation statements)
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References 193 publications
(181 reference statements)
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“…While in the preabsorptive state, nutrients activate various signaling events and trigger the release of gut-derived peptides such as CCK and GLP-1 to activate negative feedback, whole-body metabolic pathways that regulate food intake and glucose homeostasis (107,108). In fact, direct inhibition of small intestinal CCK receptor (92) or knockdown of GLP-1 receptors in the vagal afferent nerves (93) disrupt glucose homeostasis in rodents, indicating that a gut/brain axis mediates the ability of nutrient-dependent CCK and GLP-1 action to regulate glucose homeostasis.…”
Section: Figure 2 An Integrative and Neuronal-dependent Intestinal Imentioning
confidence: 99%
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“…While in the preabsorptive state, nutrients activate various signaling events and trigger the release of gut-derived peptides such as CCK and GLP-1 to activate negative feedback, whole-body metabolic pathways that regulate food intake and glucose homeostasis (107,108). In fact, direct inhibition of small intestinal CCK receptor (92) or knockdown of GLP-1 receptors in the vagal afferent nerves (93) disrupt glucose homeostasis in rodents, indicating that a gut/brain axis mediates the ability of nutrient-dependent CCK and GLP-1 action to regulate glucose homeostasis.…”
Section: Figure 2 An Integrative and Neuronal-dependent Intestinal Imentioning
confidence: 99%
“…These studies collectively highlight the potential converging role of intestinal SCFA sensing in the regulation of immunity and whole-body glucose homeostasis (Figure 2). Changes in gut microbiota are not only associated with obesity and diabetes but also with changes of intestinal immunity, as well as metformin and bariatric surgical therapies (107). The potential mechanistic links between metformin and bariatric surgery as well as small intestinal nutrient-sensing mechanisms in lowering plasma glucose have been reviewed elsewhere (107).…”
Section: Figure 2 An Integrative and Neuronal-dependent Intestinal Imentioning
confidence: 99%
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“…Although the medical and technological knowledge of these disorders has improved tremendously, the pathogenesis of diabetes remains poorly understood, and efficient therapeutic tools are still lacking. In this respect, the success of gastric bypass surgery and new promising gut-derived pharmacological treatments, such as the use of glucagon-like peptide-1 (GLP-1) analogs, highlights the importance of the gastrointestinal tract in regulating glucose homeostasis (23). Moreover, the socalled "gut-brain axis" is currently an intriguing topic in the search for new antidiabetic tools (23).…”
mentioning
confidence: 99%
“…In this respect, the success of gastric bypass surgery and new promising gut-derived pharmacological treatments, such as the use of glucagon-like peptide-1 (GLP-1) analogs, highlights the importance of the gastrointestinal tract in regulating glucose homeostasis (23). Moreover, the socalled "gut-brain axis" is currently an intriguing topic in the search for new antidiabetic tools (23). Thus, a better understanding of the pathways involved in glucosensing inside and outside the gastrointestinal tract will likely contribute to the identification of future therapeutic targets for the treatment of diabetes.…”
mentioning
confidence: 99%