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From Entero-Endocrine Cell Biology to Surgical Interventional Therapies for Type 2 Diabetes

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Diabetes: from Research to Clinical Practice

Part of the book series: Advances in Experimental Medicine and Biology ((AIM,volume 1307))

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 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.

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Abbreviations

ADA:

American Diabetes Association

BMI:

Body mass index

BPD:

Biliopancreatic diversion

BPD-DS:

Biliopancreatic diversion with duodenal switch

CCK:

Cholecystokinin

DJBL:

Duodenal-Jejunal Bypass Liner

DMR:

Duodenal mucosal resurfacing

DSS-II:

Second Diabetes Surgery Summit

EEC:

Enteroendocrine cells

ESG:

Endoscopic Sleeve Gastroplasty

EWL:

Excess weight-loss

Gcg:

Preproglucagon gene

GcGR:

Glucagon receptor

GERD:

Gastroesophageal reflux disease

GI:

Gastrointestinal

GIP:

Glucose-dependent insulinotropic polypeptide

GJB:

Gastrojejunal bypass

GLP-1:

Glucagon-like peptide-1

GLP-1R:

Glucagon-like peptide-1 receptor

HbA1c:

Hemoglobin A1c

IFSO:

International Federation for the Surgery of Obesity

LSG:

Laparoscopic sleeve gastrectomy

MNU:

Neuromedin U

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

OHS:

Obesity-hypoventilation syndrome

OSA:

Obstructive sleep apnea

OXM:

Oxyntomodulin

PYY:

Peptide YY

RCTs:

Randomized clinical trials

RYGB:

Roux-en-Y Gastric Bypass

SADI-S:

Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy

T2D:

Type 2 Diabetes

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Authors and Affiliations

  1. Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal

    Marta Guimarães, Sofia S. Pereira & Mariana P. Monteiro

  2. Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal

    Marta Guimarães, Sofia S. Pereira & Mariana P. Monteiro

  3. Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

    Marta Guimarães

  4. Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal

    Sofia S. Pereira

  5. Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal

    Sofia S. Pereira

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  1. Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden, Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden

    Md. Shahidul Islam

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Guimarães, M., Pereira, S.S., Monteiro, M.P. (2020). From Entero-Endocrine Cell Biology to Surgical Interventional Therapies for Type 2 Diabetes. In: Islam, M.S. (eds) Diabetes: from Research to Clinical Practice. Advances in Experimental Medicine and Biology(), vol 1307. Springer, Cham. https://doi.org/10.1007/5584_2020_480

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