Harnessing the gut-brain axis in the treatment of type 2 diabetes mellitus and obesity

Abstract

Introduction and aim. The most common metabolic disorders include type 2 diabetes (T2DM) and obesity. Their prevalence has increased in recent years. Due to their widespread prevalence and the fact that they increase the risk of cardiovascular disease, morbidity, and mortality, they pose a significant economic burden to the healthcare system. In this review, we will focus primarily on the role of gut hormone signaling produced by enteroendocrine cells (EECs), which are part of the gut-brain axis. Furthermore we will summarize applications of these mechanisms in novel therapies for T2DM and obesity. Material and method. Literature data analysis was performed using the following databases: PubMed (MEDLINE), Scopus, Web of Science and Google Scholar. The review included articles in Polish and English published between 2000 and 2024. Analysis of the literature. EECs are specialized transepithelial cells present throughout the intestine. The best-studied EEC subtype is the L cell, which secretes glucagon-like peptide-1 (GLP-1). GLP-1 regulates insulin secretion and contributes to satiety by increasing insulin secretion and inhibiting glucagon secretion. Significant progress in the use of intestinal hormones in the treatment of T2DM and obesity has led to the development of effective therapies for both of these conditions, such as GLP-1 analogs. Conclusion. The growing understanding of biochemical processes, hormonal signaling, and the development of new technologies contribute to the continuation of research on new, more effective therapies that use mechanisms of action of the gut-brain axis. Despite these achievements, the need for new and more effective treatments is constantly growing, and requires innovative strategies and their potential combination with existing therapies.