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. 2018 Sep 10;9:530. doi: 10.3389/fendo.2018.00530

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Copyright © 2018 Laferrère and Pattou.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Mechanistic model of improved glycemia after RYGB. RYGB improves glucose metabolism via weight loss, and via weight-independent mechanisms, including stimulation of gut peptides, alteration of bile acids enterohepatic cycle, remodeling of the gastrointestinal track, and alteration of the microbiome. Solid lines: evidence based mechanisms; dashed lines: possible mechanisms. RYGB, Roux-en-Y gastric bypass surgery; HGP, hepatic glucose production; BA derivation, bile acids derivation; GI, gastro intestinal; GNG, gluconeogenesis; GLP-1, glucagon-like-peptide 1; PYY, peptide YY; OXY, oxyntomodulin; GSIS, glucose-stimulated insulin secretion; PPG, post-prandial glucose; ↑: increase; ↓: decrease.