Our researchers are developing a vagus nerve stimulation device to lower blood sugar levels to treat type 2 diabetes.

• Researchers at the Bionics Institute are developing a new medical device that activates the body’s natural processes to treat type 2 diabetes.
• Despite advancements in new medicines, many people experience poorly controlled type 2 diabetes and medication side effects.
• The aim of our research is to develop a drug-free treatment that stimulates the body to correct itself when blood sugar levels are too high.
  
  

Why is a new treatment for type 2 diabetes needed?

Diabetes is a chronic, progressive condition that affects over 415 million people worldwide.

People with diabetes experience high blood sugar levels, which can eventually damage their body’s organs, causing eye disease, stroke, heart attacks and death.

For this reason it is a huge burden on the economy with the total costs of treating people diagnosed with diabetes estimated to be USD $623 billion globally.

Around 90% of this number suffer from type 2 diabetes, which is associated with lifestyle and genetic factors.

The issue with controlling blood sugar in type 2 diabetes

Insulin, a hormone produced by the pancreas is critical to maintain blood sugar levels in a normal, healthy range.

Type 2 diabetes initially leads to insulin resistance, followed by not enough insulin being produced by the pancreas.

Despite advancements in drug therapies, type 2 diabetes is poorly controlled in many people, who are unable to keep their blood sugar levels within a healthy range.

In addition, common treatments are often inconvenient to administer and can cause unpleasant side effects.

It is therefore important that alternative treatments are developed to help people keep blood sugar in a healthy range and improve long-term health outcomes for people with type 2 diabetes.

Treating type 2 diabetes with electrical stimulation

The vagus nerve runs from the brain to the gut and controls many processes in the body, including the release of hormones to control blood sugar levels.

Researchers at the Bionics Institute are in the early stages of adapting a vagus nerve stimulation device, previously developed to treat inflammatory bowel disease, to treat type 2 diabetes.

By stimulating a specific part of the vagus nerve, researchers have shown that it is possible to kick-start the body’s natural mechanisms to lower blood sugar levels, with fewer side effects than drugs.

Working towards an implant that automatically lowers blood sugar levels

This new and incredibly innovative device will eventually be implanted into people with uncontrolled type 2 diabetes using key-hole surgery.

The aim is for stimulation of the vagus nerve to be switched on automatically after eating to control blood sugar levels and improve overall health of people with type 2 diabetes.

Next steps for Bionics Institute researchers

The vagus nerve stimulation device that has been developed to treat inflammatory bowel disease has passed safety tests for use in humans and will be moving into clinical trials in 2022.

As the type 2 diabetes device uses similar technology, this approval for use in clinical trials will accelerate its development.

Our next steps are to consolidate pre-clinical data and start planning for a clinical trial, in collaboration with our clinical collaborators.

The research team

Bionics Institute researchers: Professor James Fallon (PI), Dr Joel Villalobos, Dr Sophie Payne, Dr Tomoko Hyakumura

External researchers: Associate Professor Sof Andrikopoulos (Austin Health), Professor John Prins (University of Melbourne)

Clinical collaborators: Professor Richard J. MacIsaac (St Vincent’s Hospital), Associate Professor Glenn Ward (St Vincent’s Hospital)

More information for researchers

Bionic medicine is emerging as a promising alternative treatment for chronic diseases as it aims to rapidly adapt to the patient’s fluctuating condition to provide real-time, patient-specific therapy.

Furthermore, it offers a reduction in side effects and long-term costs (Vitale and Litt, 2018), and could provide a fully internal, automated system with a high medical adherence and minimal interference to the patient’s activities during the day (Payne et al., 2019; Alliance for Advancing Bioelectronic, 2020; Cho et al., 2020; Guemes Gonzalez et al., 2020).

Electrical modulation of the vagus nerve to lower high glucose levels to improve glycaemic control has been the focus of research (Malbert, 2018; Guemes Gonzalez et al., 2020) as this autonomic nerve is involved in the regulation of food intake, glucose metabolism and homeostasis and influences the overall dynamics of insulin secretion (Travagli and Browning, 2011; Waise et al., 2018).

We have developed a unique stimulation strategy that allows selective activation of efferent (motor) vagal fibres, while also inhibiting afferent pathways to the brain. We have demonstrated that this ‘efferent vagus nerve stimulation’ strategy is safe and efficacious at lowering glycaemia over a short period-of-time in a preclinical model of type 2 diabetes.

Future studies are investigating an optimal stimulation strategy that leads to the long-term reduction of glycaemia and improvement in diabetic symptoms.

Publications

Payne et al., 2020 Physiol Rep. https://doi.org/10.14814/phy2.14479
Payne et al., 2018 Nat Rev: Gastrol & Hep https://doi.org/10.1038/s41575-018-0078-6

References
1. Diabetes globally – Diabetes Australia