CE Hours: 1

Seq#279 - Distinguished Lecture Series: The Gut - Its Role in the Development of Obesity and Diabetes - Jens Juul Holst

Obesity develops because of imbalance of energy intake and expenditure. The absorptive organ, the gut, would not be expected to be involved in the development of obesity and type 2 diabetes but the gut participates in the regulation of appetite and hence food intake. The gut also has a major influence on the digestion and absorption of nutrients and therefore is an important regulator of metabolism. One of the most important mechanisms responsible for the secretion of hormones from the gut is ghrelin which promotes food intake, and glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), both of which have anorexic effects.

The importance of these hormones emerges from studies of bariatric surgeries, in particular gastric bypass surgery, where weight loss results from suppression of appetite with ensuing reductions in food intake. Several recent studies support that changes in gut hormone secretion are responsible for this. Weight loss is clearly an important factor for diabetes resolution post operations, but some of the gut hormones also enhance insulin secretion and thereby improve glycemic control. For GLP-1, these actions are now being exploited not only in the therapy of type 2 diabetes but also in the combat of obesity and its complications. The most recent results show body weight losses exceeding 15% in more than half of the patients and leading to 80% reductions in the occurrence of obesity-related type 2 diabetes.

Learning Objectives:

  • The gut importantly regulates postprandial nutrient levels; Gut hormones play an essential role in the regulation of appetite and food intake
  • Gastric bypass operations results in dramatic changes in gut hormone secretion which play a major role for the weight loss and diabetes resolution following the operations
  • The anti-diabetic and weight-losing properties of one of them, glucagon-like peptide-1 (GLP-1), has led to the development of GLP-1 receptor agonists, which are now among the most effective therapies for both diabetes and obesity.