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. 2018 Sep 25;4:58. doi: 10.1038/s41421-018-0062-x

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© The Author(s) 2018

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 8 — Excluding the stomach and duodenum by RYGB in rats largely reduces energy intake, which further decreases insulin production and inhibits the insulin signaling pathway in the liver, skeletal muscle and fat. Thus, insulin-independent metabolic pathways are triggered, including enhanced glycolysis, fatty acid oxidation and gluconeogenesis. Consequently, glucose homeostasis is initiated by non-insulin determinant metabolic pathways. IR insulin receptor