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Duodenal energy sensing regulates hepatic glucose output

Nature Medicine volume 21, pages 428–429 (2015)Cite this article

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The maintenance of blood glucose involves the coordination of multiple organ systems. Two new studies indicate that metformin and resveratrol activate metabolic sensors in the duodenum and initiate a neural loop that reduces liver glucose production in rat models of type 2 diabetes.

Type 2 diabetes is characterized by chronically elevated blood glucose, which has deleterious side effects on all organ systems. Hyperglycemia is driven by impaired rates of peripheral glucose uptake and elevated rates of hepatic glucose output (HGO); therefore, an understanding of the mechanisms regulating these processes is vital for optimizing the use of existing glucose-lowering therapies and for developing new ones. In this issue of Nature Medicine, two manuscripts1,2 highlight a gut-brain-liver communication axis crucial to suppressing HGO in response to metformin, the most widely used therapy for type 2 diabetes, and resveratrol, a polyphenol with antidiabetic effects.

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Figure 1: Proposed mechanism by which metformin and resveratrol lower hepatic glucose output.

Kim Caesar/Nature Publishing Group

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Authors and Affiliations

  1. Brennan K. Smith and Gregory R. Steinberg are in the Division of Endocrinology and Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,

    Brennan K Smith & Gregory R Steinberg

  2. Gregory R. Steinberg is also in the Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,

    Gregory R Steinberg

Authors
  1. Brennan K Smith
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  2. Gregory R Steinberg
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Correspondence to Gregory R Steinberg.

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The authors declare no competing financial interests.

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Smith, B., Steinberg, G. Duodenal energy sensing regulates hepatic glucose output. Nat Med 21, 428–429 (2015). https://doi.org/10.1038/nm.3859

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