Importance of the gastrointestinal tract in type 2 diabetes. Metabolic surgery is more than just incretin effect

Abstract

Bariatric and metabolic surgery is creating new concepts about how the intestine assimilates food. Recent studies highlight the role of the gastrointestinal tract in the genesis and evolution of type 2 diabetes. This article has been written to answer frequent questions about metabolic surgery results and the mechanisms of action. For this purpose, a non-systematic search of different databases was carried out, identifying articles published in the last decade referring to the mechanisms of action of metabolic techniques. Understanding these mechanisms will help grasp why some surgeries are more effective than others and why the results can be so disparate among patients undergoing the same surgical approach.

Keywords: Bile acid; Cirugía metabólica; Enteroplasticidad; Enteroplasticity; Glucotransportadores; Glucotransporters; Incretin effect; Incretinas; Intestinal transit; Metabolic surgery; Microbiota; Tránsito intestinal; Ácidos biliares.