Neuromodulation : journal of the International Neuromodulation Society · 2025
Lateral Epidural Stimulation to Decrease Glucose Levels: A Preliminary Preclinical Study.
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Sokal Adam, Chodakowski Pawel, Bogusz Alicja, Bogus Piotr, Eggen Mike, Bhattacharya Abhijt, Kornet Lilian
Аннотация
BACKGROUND: Medical therapy in patients with type 2 diabetes (T2D) often has side effects and poor tolerance. Therefore, a device-based therapy may be more desirable.
OBJECTIVE: We investigated whether increased dorsal root nerve activity by lateral epidural stimulation (LES) around T9-T10 indirectly decreases glucose levels.
MATERIALS AND METHODS: In this animal study, it was first tested whether LES at various vertebra levels influences insulin secretion and subsequent glucose blood level. After finding the optimal stimulation site, glucose tolerance tests were performed to study the effect of LES on glucose and insulin before and during these tests. C-peptide was used as a surrogate for insulin.
RESULTS: The optimal location of the electrode pairs to have the greatest effect on C-peptide was location T9-T10. Given the effect on glucose was not present in a euglycemic state, a hyperglycemic state was induced using an intravenous glucose tolerance (IVGT) test provoking a change in C-peptide (n = 6). The increase in C-peptide during the first 90 minutes of the IVGT test was greater during LES than during no stimulation (p = 0.024, two-sided paired t-test). The glucose decay time constant was more negative during LES than during no stimulation; that is, glucose was eliminated faster from the bloodstream (p = 0.045, two-sided paired t-test).
CONCLUSION: LES therapy seems to be a promising therapy to be used in patients who are noncompliant and have T2D or those having side effects with conventional medications, to affect insulin secretion and subsequently glucose blood level when in a hyperglycemic state.
OBJECTIVE: We investigated whether increased dorsal root nerve activity by lateral epidural stimulation (LES) around T9-T10 indirectly decreases glucose levels.
MATERIALS AND METHODS: In this animal study, it was first tested whether LES at various vertebra levels influences insulin secretion and subsequent glucose blood level. After finding the optimal stimulation site, glucose tolerance tests were performed to study the effect of LES on glucose and insulin before and during these tests. C-peptide was used as a surrogate for insulin.
RESULTS: The optimal location of the electrode pairs to have the greatest effect on C-peptide was location T9-T10. Given the effect on glucose was not present in a euglycemic state, a hyperglycemic state was induced using an intravenous glucose tolerance (IVGT) test provoking a change in C-peptide (n = 6). The increase in C-peptide during the first 90 minutes of the IVGT test was greater during LES than during no stimulation (p = 0.024, two-sided paired t-test). The glucose decay time constant was more negative during LES than during no stimulation; that is, glucose was eliminated faster from the bloodstream (p = 0.045, two-sided paired t-test).
CONCLUSION: LES therapy seems to be a promising therapy to be used in patients who are noncompliant and have T2D or those having side effects with conventional medications, to affect insulin secretion and subsequently glucose blood level when in a hyperglycemic state.