From Entero-Endocrine Cell Biology to Surgical Interventional Therapies for Type 2 Diabetes
The physiological roles of the enteroendocrine system in relation to energy and glucose homeostasis regulation have been extensively studied in the past few decades. Considerable advances were made that enabled to disclose the potential use of gastro-inte
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From Entero-Endocrine Cell Biology to Surgical Interventional Therapies for Type 2 Diabetes Marta Guimarães, Sofia S. Pereira, and Mariana P. Monteiro Abstract
The physiological roles of the enteroendocrine system in relation to energy and glucose homeostasis regulation have been extensively studied in the past few decades. Considerable advances were made that enabled to disclose M. Guimarães Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal S. S. Pereira Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal M. P. Monteiro (*) Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal e-mail: [email protected]
the potential use of gastro-intestinal (GI) hormones to target obesity and type 2 diabetes (T2D). The recognition of the clinical relevance of these discoveries has led the pharmaceutical industry to design several hormone analogues to either to mitigate physiological defects or target pharmacologically T2D. Amongst several advances, a major breakthrough in the field was the unexpected observation that enteroendocrine system modulation to T2D target could be achieved by surgically induced anatomical rearrangement of the GI tract. These findings resulted from the widespread use of bariatric surgery procedures for obesity treatment, which despite initially devised to induce weight loss by limiting the systemic availably of nutrients, are now well recognized to influence GI hormone dynamics in a manner that is highly dependent on the type of anatomical rearrangement produced. This chapter will focus on enteroendocrine system related mechanisms leading to improved glycemic control in T2D after bariatric surgery interventions. Keywords
Bariatric surgery · Endoscopic interventions · Enteroendocrine system · Gastrointestinal hormones · GIP · GLP-1 · Obesity · Oxyntomodulin · Peptide YY · Type 2 diabetes
M. Guimarães et al.
Abbreviations ADA BMI BPD BPDDS CCK DJBL DMR DSS-II EEC ESG EWL Gcg GcGR GERD GI GIP GJB GLP-1 GLP1R HbA1c IFSO LSG MNU NAFLD NASH OHS OSA OXM PYY RCTs RYGB SADI-S T2D
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