Diabetes is predominantly an intestinal disease.

Area of Science:

• Endocrinology
• Gastroenterology
• Microbiome Research

Background:

• Diabetes mellitus (DM) is a chronic, progressive disease with poor control in most patients despite pharmacotherapy.
• Altered gut microbiome composition is linked to diabetes prediction and glucose homeostasis.
• Gut hormones, such as incretins, play a significant role in energy and glucose regulation.

Purpose of the Study:

• To explore the concept of type 2 diabetes mellitus (T2DM) as a potentially operable intestinal illness.
• To highlight the role of the gut and incretins in glucose homeostasis.
• To identify new research directions for understanding T2DM etiology and developing novel therapies.

Main Methods:

• Review of existing evidence on gut microbiome, incretins, and their role in glucose homeostasis.
• Analysis of the concept of T2DM as an intestinal illness.
• Discussion of therapeutic implications of incretin-based agents (GLP-1 receptor agonists, DPP-IV inhibitors).

Main Results:

• Incretin-based therapies are effective for T2DM treatment.
• Growing evidence suggests T2DM may be fundamentally an intestinal disorder.
• This novel perspective could drive research into disease etiology and treatment.

Conclusions:

• T2DM may be viewed as an operable intestinal illness, a revolutionary concept for an old disease.
• Further research is needed to clarify the etiology and develop more effective, less invasive therapies.
• Future strategies should aim to replace invasive treatments like gastric bypass with equally effective, less invasive alternatives.