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This communication happens via the gut-brain axis, a complex network linking the digestive system and the central nervous system

FDA Guidance for Industry and FDA Staff

Journal of the Endocrine Society, 8 (11), bvae164

We have first shown that exogenous cholesterol increases via prolonged dietary changes lead to a decrease in the capacity of the GLP-1R for in vivo glucoregulation, without affecting glucose levels under vehicle conditions

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Longer intestinal urea concentrations in response to increased blood urea nitrogen (BUN) and increased colonic transit time have long been thought to disrupt the carbohydrate-to-protein balance, resulting in the dysbiosis shown in CKD (Vaziri, 2012