Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China.
Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China.
Metabolism. 2024 Mar;152:155743. doi: 10.1016/j.metabol.2023.155743. Epub 2023 Nov 24.
The gut has been increasingly recognized in recent years as a pivotal organ in the maintenance of glucose homeostasis. Specifically, the profound and enduring improvement in glucose metabolism achieved through metabolic surgery to modify the anatomy of the gut has prompted scholars to acknowledge that the most effective strategy for treating type 2 diabetes mellitus (T2DM) involves the gut. The mechanisms underlying the regulation of glucose metabolism by the gut encompass gut hormones, bile acids, intestinal gluconeogenesis, gut microbiota, and signaling interactions between the gut and other organs (liver, brain, adipose, etc.). Recent studies have also revealed a novel phenomenon of glucose lowering through the gut: metabolic surgery and metformin promote the excretion of glucose from the circulation into the intestinal lumen by enterocytes. However, there is still limited understanding regarding the underlying mechanisms of intestinal glucose excretion and its contribution to glycemic control. This article reviews current research on intestinal glucose excretion while focusing on its role in T2DM management as well as potential mechanisms.
近年来，人们越来越认识到肠道是维持葡萄糖内稳态的关键器官。具体来说，通过代谢手术改变肠道解剖结构来改善葡萄糖代谢的深远而持久的效果，促使学者们承认治疗 2 型糖尿病（T2DM）最有效的策略涉及肠道。肠道调节葡萄糖代谢的机制包括肠道激素、胆汁酸、肠内葡萄糖生成、肠道微生物群以及肠道与其他器官（肝脏、大脑、脂肪等）之间的信号相互作用。最近的研究还揭示了通过肠道降低血糖的一种新现象：代谢手术和二甲双胍通过肠细胞促进葡萄糖从循环中排出到肠腔中。然而，对于肠道葡萄糖排泄的潜在机制及其对血糖控制的贡献，仍知之甚少。本文综述了目前关于肠道葡萄糖排泄的研究，重点介绍了其在 T2DM 管理中的作用以及潜在的机制。
