Effect of antidiabetic drugs on gut endocrine function after metabolic and bariatric surgery: a systematic review
Abstract
Abstract Objective The management of diabetes after metabolic and bariatric surgery (MBS) is not yet supported by strong evidence-based recommendations, and the mechanisms of action of antidiabetic drugs in this setting remain poorly defined. In particular, intestinal responses to these medications may be altered following surgery. This review aimed to synthesize current knowledge on the effects of antidiabetic drugs on gut hormone secretion after MBS. Design and methods A systematic review was conducted through searches of PubMed, Embase, and ClinicalTrials.gov. Eligible studies included clinical or preclinical investigations assessing gut hormone responses to antidiabetic drugs following MBS. Results The search, updated on August 28, 2025, identified 7781 references, of which only 8 original articles met the inclusion criteria. These studies, all conducted in humans, reported gut hormone responses to sitagliptin, liraglutide, empagliflozin, and canagliflozin after MBS. GLP-1 secretion was increased by sitagliptin following Roux-en-Y gastric bypass suggesting a synergistic effect. In addition, sitagliptin enhanced and restored GIP responses to meal testing. The results concerning GLP-1 measurements under treatment with GLP-1R agonist (liraglutide) were inconsistent. No studies were identified concerning sleeve gastrectomy—the most frequently performed bariatric procedure—or metformin, the most commonly prescribed antidiabetic drug. Conclusions This review highlights the…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.