title: Gut: A key player in the pathogenesis of type 2 diabetes?
abstract: The gut regulates glucose and energy homeostasis; thus, the presence of ingested nutrients into the gut activates sensing mechanisms that affect both glucose homeostasis and regulate food intake. Increasing evidence suggest that gut may also play a key role in the pathogenesis of type 2 diabetes which may be related to both the intestinal microbiological profile and patterns of gut hormones secretion. Intestinal microbiota includes trillions of microorganisms but its composition and function may be adversely affected in type 2 diabetes. The intestinal microbiota may be responsible of the secretion of molecules that may impair insulin secretion/action. At the same time, intestinal milieu regulates the secretion of hormones such as GLP-1, GIP, ghrelin, gastrin, somatostatin, CCK, serotonin, peptide YY, GLP-2, all of which importantly influence metabolism in general and in particular glucose metabolism. Thus, the aim of this paper is to review the current evidence on the role of the gut in the pathogenesis of type 2 diabetes, taking into account both hormonal and microbiological aspects.
authors.affiliation: a I.O.S. & COLEMAN Srl , Naples , Italy.
authors.forename: Giovanna
authors.identifier: http://orcid.org/0000-0002-8809-4931
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: b Division of Endocrinology, Department of Clinical and Molecular Sciences , Umberto I Hospital, Polytechnic University of Marche , Ancona , Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.affiliation: a I.O.S. & COLEMAN Srl , Naples , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barrea
authors.affiliation: c Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases , University of Bari Aldo Moro , Bari , Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cignarelli
authors.affiliation: c Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases , University of Bari Aldo Moro , Bari , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giorgino
authors.affiliation: d NNF Center for Basic Metabolic Research and Department of Biomedical Sciences , Panum Institute, University of Copenhagen, Copenhagen , Denmark.
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: a I.O.S. & COLEMAN Srl , Naples , Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Laudisio
authors.affiliation: e Endocrinology, Department of Sports Science and Wellness , "Parthenope" University Naples , Naples , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.affiliation: b Division of Endocrinology, Department of Clinical and Molecular Sciences , Umberto I Hospital, Polytechnic University of Marche , Ancona , Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tirabassi
authors.affiliation: f Department of Clinical Medicine and Surgery , "Federico II" University of Naples , Naples , Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D041981:Gastrointestinal Tract / Q000382:microbiology* / Q000502:physiology*; D005786:Gene Expression Regulation; D005947:Glucose / Q000378:metabolism; D006801:Humans
chemical_list: D005947:Glucose
keywords: GIP; GLP-1; Gut; Roux-y-gastric-by-pass; environment; lifestyle; microbiota; obesity; serotonin; type 2 diabetes