Research
Hormonal
Bile acid metabolism and the gut microbiome are critical mediators of glycemic improvement after bariatric surgery, acting through FXR and TGR5 receptors to influence glucose production and utilization.
Surgery changes how your gut processes fats and sugars, leading to beneficial changes in bile acids and gut bacteria. These changes help your liver and muscles handle glucose better, contributing to diabetes remission.
GoodSupportsMEDIUM confidence
BAs acting via TGR5 stimulate L-cell secretion of GLP-1 and PYY. Directly and indirectly through the FXR-induced antimicrobial peptides, BAs also regulate gut microbiota composition. This, in turn, has been linked to the pathogenesis of obesity and T2DM...
Why this rating
Strong evidence from animal models and correlative human data, though causality in humans is still being elucidated.
Source
Mechanisms of Diabetes Improvement Following Bariatric/Metabolic Surgery
Rachel L. Batterham et al. · Diabetes Care · 2016
DOI 10.2337/dc16-0145
narrative_reviewCited 371×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Bariatric/metabolic surgery induces rapid type 2 diabetes remission through weight-independent mechanisms, primarily involving altered gut hormone secretion (GLP-1, PYY), bile acid metabolism, and intestinal glucose disposal, occurring before significant weight loss.Strong
- The exaggerated postprandial secretion of GLP-1 and PYY following Roux-en-Y gastric bypass (RYGB) and Vertical Sleeve Gastrectomy (VSG) contributes to improved glucose tolerance and insulin sensitivity, although its necessity is debated.Good
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