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In mouse models of obesity and diabetes, hyperglycemia increases intestinal barrier permeability through GLUT2-dependent transcriptional reprogramming of intestinal epithelial cells and alters the integrity of tight and adhesion junctions.
Consequently, hyperglycemia-mediated barrier disruption leads to a systemic influx of microbial products and increased dissemination of intestinal infections. Treatment of hyperglycemia, intestinal epithelium-specific GLUT2 deletion, or inhibition of glucose metabolism restores barrier function and bacterial containment. In humans, the systemic influx of products of the gut microbiome correlates with individual glycemic control as indicated by glycated hemoglobin levels.
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