Hormonal
Targeting enteroendocrine L-cells to stimulate endogenous release of GLP-1 and PYY is a viable therapeutic strategy for treating type 2 diabetes and obesity, leveraging the gut's spare hormonal capacity.
Current GLP-1 injections are effective, but research suggests that stimulating your gut's own hormone-producing cells (L-cells) using specific nutrients or future drugs could achieve similar benefits without injections. This involves targeting receptors for fats, amino acids, and bile acids in the intestine to boost natural GLP-1 and PYY release.
I argue that there is sufficient spare capacity of GLP-1 and other gut hormone expressing cells that could be recruited therapeutically.
Why this rating
Based on a review of multiple studies, bariatric surgery outcomes, and mouse models, but lacks large-scale human trials for specific small molecule L-cell targeting.
Source
Dorothy Hodgkin lecture 2023: The enteroendocrine system—Sensors in your guts
Frank Reimann · Diabetic Medicine · 2023
DOI 10.1111/dme.15212
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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