Closed-loop bioelectronic medicine for diabetes management

Ralph Etienne-Cummings,Amparo Güemes Gonzalez,Pantelis Georgiou

doi:10.1186/s42234-020-00046-4

Ralph Etienne-Cummings, Amparo Güemes Gonzalez + Show 1 more

Open Access

https://doi.org/10.1186/s42234-020-00046-4

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Abstract

Modulation of the nervous system by delivering electrical or pharmaceutical agents has contributed to the development of novel treatments to serious health disorders. Recent advances in multidisciplinary research has enabled the emergence of a new powerful therapeutic approach called bioelectronic medicine. Bioelectronic medicine exploits the fact that every organ in our bodies is neurally innervated and thus electrical interfacing with peripheral nerves can be a potential pathway for diagnosing or treating diseases such as diabetes. In this context, a plethora of studies have confirmed the important role of the nervous system in maintaining a tight regulation of glucose homeostasis. This has initiated new research exploring the opportunities of bioelectronic medicine for improving glucose control in people with diabetes, including regulation of gastric emptying, insulin sensitivity, and secretion of pancreatic hormones. Moreover, the development of novel closed-loop strategies aims to provide effective, specific and safe interfacing with the nervous system, and thereby targeting the organ of interest. This is especially valuable in the context of chronic diseases such as diabetes, where closed-loop bioelectronic medicine promises to provide real-time, autonomous and patient-specific therapies. In this article, we present an overview of the state-of-the-art for closed-loop neuromodulation systems in relation to diabetes and discuss future related opportunities for management of this chronic disease.

Highlights

A key biological process of every living system is the maintenance of homeostasis to ensure stability via continuous and rapid self-adjustments of the physiological state
The nervous system has a major role in preserving homeostasis using closed-loop mechanisms called neural reflexes
* Correspondence: amparo.guemes15@imperial.ac.uk 1Centre for Bio-Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, UK Full list of author information is available at the end of the article have seen the introduction of bioelectronic medicine, an evolution of neuromodulation, which aims to provide real-time and patient-specific therapies by modulating the activity of specific peripheral nerves to improve or restore impaired biological function of specific organs (Vitale and Litt 2018; Medicine A for AB 2020)

Summary

Introduction

A key biological process of every living system is the maintenance of homeostasis to ensure stability via continuous and rapid self-adjustments of the physiological state. * Correspondence: amparo.guemes15@imperial.ac.uk 1Centre for Bio-Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, UK Full list of author information is available at the end of the article have seen the introduction of bioelectronic medicine, an evolution of neuromodulation, which aims to provide real-time and patient-specific therapies by modulating the activity of specific peripheral nerves to improve or restore impaired biological function of specific organs (Vitale and Litt 2018; Medicine A for AB 2020).

Results

Conclusion