title: 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 antidiabetic agents metformin and resveratrol. A better understanding of these pathways lays the groundwork for intestinally targeted drug therapy for the treatment of diabetes.
authors.affiliation: Toronto General Research Institute and Department of Medicine, UHN, Toronto, ON M5G 1L7, Canada.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Duca
authors.affiliation: Toronto General Research Institute and Department of Medicine, UHN, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada.
authors.forename: Paige V
authors.initials: PV
authors.lastname: Bauer
authors.affiliation: Toronto General Research Institute and Department of Medicine, UHN, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada.
authors.forename: Sophie C
authors.initials: SC
authors.lastname: Hamr
authors.affiliation: Toronto General Research Institute and Department of Medicine, UHN, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Banting and Best Diabetes Centre, University of Toronto, Toronto, ON M5G 2C4, Canada. Electronic address: tony.lam@uhnres.utoronto.ca.
authors.forename: Tony K T
authors.initials: TK
authors.lastname: Lam
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000187:drug effects / Q000502:physiology*; D005947:Glucose / Q000378:metabolism*; D000067940:Glycemic Load / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007421:Intestine, Small / Q000187:drug effects / Q000502:physiology* / Q000601:surgery; D008099:Liver / Q000187:drug effects / Q000502:physiology; D008687:Metformin / Q000494:pharmacology; D009747:Nutritional Physiological Phenomena / Q000187:drug effects; D000077185:Resveratrol; D013267:Stilbenes / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D013267:Stilbenes; D008687:Metformin; D005947:Glucose; D000077185:Resveratrol