Impact of drug treatment using GLP1/GIP1 agonist vs Bariatric Surgery on insulin signaling and insulin Resistance and Lipid Metabolism

Bariatric surgery is becoming increasingly utilized as a weight management and metabolic control procedure hence the name metabolic Surgery. Various experimental studies in animal and human clinical trials are investigating mechanisms behind this rapid-onset and long-lasting improvement. Its effectiveness in diabetes remission has phenomenal and provide hope for a long-lasting treatment of diabetes particularly when combined with newer diabetes medications such as GLP agonist. The significance of the incretin peptides, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), on glucose and insulin homeostasis is well known. GLP1, an anorectic gut hormone released from L cells of large intestine, distal ileum and is widely used to treat obesity and diabetes. Several GLP-1 receptor agonists (Exenatide, liraglutide, Semaglutide) have shown its beneficial effect to improve glucose-dependent insulin secretion, reduce glucagon secretion, reduce food intake by slowing gastric emptying and increasing satiety. Combined GIPR and GLP1R activation has emerged as a potential therapeutic tool in the treatment of chronic metabolic diseases like T2D. Tirzepatide (LY3298176) is a novel dual GIP and GLP-1 receptor agonist that is being developed for the treatment of type 2 diabetes.