INS and type 2 diabetes mellitus: The origin of this concept is based on the observation that subjects with T2D are characterised by a duodenal hypermotility which favours glucose absorption and contributes to hyperglycaemia.166 167 It has been demonstrated that duodenal contractions are sensed by the hypothalamus167–170 and that during diabetes the duodenal hypermotility creates aberrant afferent nervous messages to the brain.169 171 Conversely, restoring natural duodenal contraction by acting on ENS neurons restores the gut-brain axis and improves insulin sensitivity.166