Abstract
The interaction between the upper gastrointestinal tract and the endocrine system is important in the regulation of metabolism and of weight. The gastrointestinal tract has a heterogeneous cellular content and comprises a variety of cells that elaborate paracrine and endocrine mediators that collectively form the entero-endocrine system. The advent of therapy that utilizes these pathways as well as the association of bariatric surgery with diabetes remission has (re-)kindled interest in the role of the gastrointestinal tract in glucose homeostasis. In this review, we will use the changes wrought by bariatric surgery to provide insights into the various gut–pancreas interactions that maintain weight, regulate satiety, and limit glucose excursions after meal ingestion.
Highlights
Tract in the Regulation of Postprandial Glucose Metabolism?The interaction between the upper gastrointestinal tract and the endocrine system is important in the regulation of metabolism and of weight
In the United States, the prevalence of obesity is rapidly increasing with 65% of adults and 17% of adolescents and children classified as being overweight or obese [1]
Observational and prospective studies have suggested that bariatric surgery is the most effective intervention for weight loss producing an average weight loss of 30–35% that is maintained in ~60% of patients at 5 years [7]
Summary
The interaction between the upper gastrointestinal tract and the endocrine system is important in the regulation of metabolism and of weight. The gastrointestinal tract has a heterogeneous cellular content and comprises a variety of cells that elaborate paracrine and endocrine mediators that collectively form the entero-endocrine system. The advent of therapy that utilizes these pathways as well as the association of bariatric surgery with diabetes remission has (re-)kindled interest in the role of the gastrointestinal tract in glucose homeostasis. We will use the changes wrought by bariatric surgery to provide insights into the various gut–pancreas interactions that maintain weight, regulate satiety, and limit glucose excursions after meal ingestion
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