Increasing GLP-1 Circulating Levels by Bariatric Surgery or by GLP-1 Receptor Agonists Therapy: Why Are the Clinical Consequences so Different?

Figure 2

Differences on GLP-1 secretion and action between bariatric surgery and GLP-1 analogs. In contrast to GLP-1 analogs that targeted directly GLP-1 canonical receptor in peripheral tissues (brain and pancreas as examples), bariatric surgery increased GLP-1 secretion by the gut. Then, GLP-1 is detected by afferent vagus nerve fibers throughout the gut and in the portal vein. This allowed brain integration of intestinal GLP-1 secretion and consequently coordinated metabolic actions in peripheral tissues by efferent vagus nerve fibers. Pictures of organs from Servier Medical Art.