Review Article: The Emerging Interplay Among the Gastrointestinal Tract, Bile Acids and Incretins in the Pathogenesis of Diabetes and Non-alcoholic Fatty Liver Disease

A. Zarrinpar; R. Loomba


Aliment Pharmacol Ther. 2012;36(10):909-921. 

In This Article


The understanding of the pathogenesis of T2DM is continuing to evolve. Increasingly, there is renewed interest in the gut's neuroendocrine response to nutrition. Although weight loss and diet remain the mainstay of treatment for T2DM, and are the safest, a large majority of patients are either unable to lose a sufficient amount of weight or maintain their lifestyle modification to have a sustained recovery. There is strong indication that bariatric surgery for the morbidly obese who have T2DM helps patients to attain a cure of T2DM by affecting the gut's neuroendocrine response to food. Research of the gut's response to nutrition in recent years has led to new pathways and processes with a role in glucose homoeostasis (such as the incretin hormones and the bile acid pathway) and, as a result, new therapeutic targets and treatment options. Further understanding of the gastrointestinal response to nutrition will help lead a new wave of novel pharmaceutical therapies to treat T2DM and NAFLD.