Research
Hormonal
Metabolic surgery increases circulating levels of bile acids (BAs), which activate FXR and TGR5 receptors to suppress gluconeogenesis, improve insulin resistance, and stimulate GLP-1 secretion, thereby improving glucose homeostasis.
Surgery changes bile acid flow and concentration, which acts as a signaling molecule to tell the liver to stop producing excess sugar and to stimulate hormones that help insulin work better.
GoodSupportsHIGH confidence
BAs are able to suppress liver gluconeogenesis through their binding of FXR... TGR5 is another target of BAs involved in host metabolism... In ileal epithelial cells, the expression of fibroblast growth factor 19 (FGF19) increases due to FXR activation by BAs.
Why this rating
Supported by extensive mechanistic studies in humans and animal models cited in the review.
Source
Mechanism of metabolic surgery for the treatment of Type 2 Diabetes Mellitus (T2DM)
David J. Leishman et al. · Mini-invasive Surgery · 2023
DOI 10.20517/2574-1225.2023.29
narrative_review
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Metabolic surgery (RYGB/VSG) improves glycemic control and induces T2DM remission through weight-loss-independent mechanisms, specifically by altering bile acid metabolism (FXR/TGR5 pathways), increasing incretin hormones (GLP-1/PYY), and modulating the gut microbiome, in addition to caloric restriction.Good
- Metabolic surgery (VSG/RYGB) alters gut hormone profiles by increasing GLP-1 and PYY while decreasing ghrelin, leading to reduced hunger and improved satiety, which aids in sustained weight loss and glucose control.Good
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