The Enteroinsular Axis
The global incidence of diabetes mellitus is rising exponentially, with an estimated 422 million confirmed cases worldwide in 2014, in comparison to 108 million in 1980 (WHO 2016). Unsurprisingly, this is becoming a significant financial burden for all nations, with healthcare costs for diabetes predicted to rise from the current £265 billion per year to £345 billion by 2030 (WHO 2016). There are two major forms of diabetes, type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), with the vast majority of cases being T2DM . Although various environmental and genetic factors have been connected to the onset of T2DM, the most accepted cause is linked to over-nutrition and an inactive lifestyle . Thus, one of the major contributing factors to T2DM is the co-existence of obesity . Indeed, the initial treatment plan for almost all newly diagnosed T2DM patients includes key nutritional advice to balance the right amount of dietary carbohydrates, fat, protein, fiber, vitamins, and minerals with the view of maintaining a healthy lifestyle and reducing body weight . Unfortunately, in many cases, diet and lifestyle changes are not sufficient to satisfactorily manage T2DM, and pharmacotherapy is required .