Glucose is intricately regulated in human body through a complex network of hormonal and neuronal factors. A series of evidence suggests that the gastrointestinal tract and the central nervous system play prominent roles in the regulation of glucose and energy homeostasis. The gut senses the nutrient supply to co-ordinate the release of hormones that activate neuronal networks in the brain, leading to the subsequent modulation of hepatic glucose output via the gut-brain-liver axis. The gut hormones also act on multiple peripheral tissues to regulate glucose level through an insulin-dependent and/or -independent mechanism. The brain, especially the hypothalamus, could also response to the hormones such as insulin and leptin and different nutrients to modulate the glucose homeostasis. In this chapter, we review the gut-brain-liver axis and the role of this organ interaction in the control of glucose homeostasis. A better understanding of these pathways will provide novel strategies for improved glycaemic control.
Part of the book: Gluconeogenesis