The Gastrointestinal Tract as an Integrator of Mechanical and Hormonal Response to Nutrient Ingestion

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Glucose tolerance after meal ingestion in vivo is the result of multiple processes that occur in parallel. Insulin secretion together with reciprocal inhibition of glucagon secretion contributes to glucose tolerance. However, other factors beyond glucose effectiveness and insulin action require consideration. The absorption of ingested nutrients and their subsequent systemic rate of appearance largely depend on the rate of delivery of nutrients to the proximal small intestine. This is determined by the integrated response of the upper gastrointestinal tract to a meal. While gastric emptying is probably the most significant component, other factors need to be considered. This review will examine all processes that could potentially alter the fraction and rate of appearance of ingested nutrients in the peripheral circulation. Several of these processes may be potential therapeutic targets for the prevention and treatment of diabetes. Indeed, there is increased interest in gastrointestinal contributions to nutritional homeostasis, as demonstrated by the advent of antidiabetes therapies that alter gastrointestinal motility, the effect of bariatric surgery on diabetes remission, and the potential of the intestinal microbiome as a modulator of human metabolism. The overall goal of this review is to examine current knowledge of the gastrointestinal contributions to metabolic control.

Original languageEnglish (US)
Pages (from-to)2729-2737
Number of pages9
JournalDiabetes
Volume66
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Gastrointestinal Tract
Eating
Glucose
Food
Meals
Insulin
Upper Gastrointestinal Tract
Gastrointestinal Motility
Bariatric Surgery
Gastric Emptying
Glucagon
Small Intestine
Homeostasis
Therapeutics
Gastrointestinal Microbiome

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

The Gastrointestinal Tract as an Integrator of Mechanical and Hormonal Response to Nutrient Ingestion. / Vella, Adrian; Camilleri, Michael.

In: Diabetes, Vol. 66, No. 11, 01.11.2017, p. 2729-2737.

Research output: Contribution to journalReview article

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