These effects depend on interactions with the host’s systemic inflammatory response and genetic background (139).Patients undergoing bariatric surgery (especially gastric bypass procedures) show improvements in insulin sensitivity, which are correlated with increased BA concentrations in circulation and alterations in intestinal microbiome, indicating that elevations in circulating BAs and the interaction of BAs and gut flora following bariatric surgery as well as calorie restriction and body mass loss lead to T2DM remission (140). Here, INS is linked to type 2 diabetes mellitus.