title: Gut-brain mechanisms controlling glucose homeostasis.
abstract: Our current understanding of glucose homeostasis is centered on glucose-induced secretion of insulin from pancreatic islets and insulin action on glucose metabolism in peripheral tissues. In addition, however, recent evidence suggests that neurocircuits located within a brain-centered glucoregulatory system work cooperatively with pancreatic islets to promote glucose homeostasis. Among key observations is evidence that, in addition to insulin-dependent mechanisms, the brain has the capacity to potently lower blood glucose levels via mechanisms that are insulin-independent, some of which are activated by signals emanating from the gastrointestinal tract. This review highlights evidence supporting a key role for a "gut-brain-liver axis" in control of glucose homeostasis by the brain-centered glucoregulatory system and the implications of this regulatory system for diabetes pathogenesis and treatment.
authors.affiliation: Diabetes and Obesity Center of Excellence, Department of Medicine, University of Washington at South Lake Union 850 Republican Street, N335, Box 358055, Seattle, WA 98195 USA ; Department of Pediatric Gastroenterology and Hepatology, Seattle Children's Hospital OB.9.620.1, P.O. Box 5371, Seattle, WA 98105 USA.
authors.forename: Jarrad M
authors.initials: JM
authors.lastname: Scarlett
authors.affiliation: Diabetes and Obesity Center of Excellence, Department of Medicine, University of Washington at South Lake Union 850 Republican Street, N335, Box 358055, Seattle, WA 98195 USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Schwartz