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A Synergy between Incretin Effect and Intestinal Gluconeogenesis Accounting for the Rapid Metabolic Benefits of Gastric Bypass Surgery

  • Pathogenesis of Type 2 Diabetes and Insulin Resistance (R Watanabe, Section Editor)
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Abstract

The early improvement of glucose control taking place shortly after gastric bypass surgery in obese diabetic patients has long been mysterious. A recent study in mice has highlighted some specific mechanisms underlying this phenomenon. The specificity of gastric bypass in obese diabetic mice relates to major changes in the sensations of hunger and to rapid improvement of glucose parameters. The induction of intestinal gluconeogenesis plays a major role in diminishing hunger, and in restoring insulin sensitivity of endogenous glucose production. In parallel, the restoration of the secretion of glucagon-like peptide 1 and insulin plays a key additional role, in this context of recovered insulin sensitivity, to improve postprandial glucose tolerance. Therefore, a synergy between an incretin effect and intestinal gluconeogenesis is a key feature accounting for the rapid improvement of glucose control in obese diabetic patients after bypass surgery.

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Acknowledgments

The author thanks all the collaborators who have participated in the works related to the present review, especially Filipe De Vadder for precious help in the critical reviewing of the English spelling of the manuscript.

Disclosure

Conflicts of interest: G. Mithieux: is employed by Centre National de la Recherche Scientifique; and has received grant support from National Agency of Research, Fondation de la Recherche Médicale, and Association Francophone des Glycogénoses.

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Authors and Affiliations

  1. UMR Inserm U855, Faculty of Medicine Laennec, rue Guillaume Paradin, 69372, Lyon Cedex 08, France

    Gilles Mithieux

  2. Université Lyon 1, Villeurbanne, France

    Gilles Mithieux

  3. Université de Lyon, Lyon, France

    Gilles Mithieux

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Correspondence to Gilles Mithieux.

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Mithieux, G. A Synergy between Incretin Effect and Intestinal Gluconeogenesis Accounting for the Rapid Metabolic Benefits of Gastric Bypass Surgery. Curr Diab Rep 12, 167–171 (2012). https://doi.org/10.1007/s11892-012-0257-8

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  • DOI: https://doi.org/10.1007/s11892-012-0257-8

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