Diabetes successfully treated with ultrasound in a preclinical study

(ORDO NEWS) — A promising new study shows that type 2 diabetes can be treated without drugs. Using three different animal models, the researchers demonstrated how short pulses of ultrasound directed at specific clusters of nerves in the liver can effectively lower insulin and glucose levels.

As reported in the journal Nature Biomedical Engineering, a GE Research-led team including researchers from the Yale School of Medicine, the University of California and the Feinstein Institute for Medical Research has demonstrated a unique, non-invasive ultrasound technique designed to stimulate specific sensory nerves in the liver.

The technology is called Peripheral Focused Ultrasound Stimulation (pFUS) and allows highly targeted ultrasound pulses to be directed to specific tissues containing nerve endings.

“We used this technique to study the stimulation of an area of ​​the liver called porta hepatis,” the researchers explained in a briefing in the journal Nature.

“This area contains the hepatoportal plexus, which relays glucose and nutrient status information to the brain, but has been difficult to study because the neural structures are too small to be stimulated individually with implanted electrodes.”

A recently published study shows that short targeted pFUS pulses in this region of the liver successfully reverse the onset of hyperglycemia. The treatment has been found to be effective in three separate animal models of diabetes: mice, rats and pigs.

“Unfortunately, there are currently very few drugs that lower insulin levels,” said Raimund Herzog, an endocrinologist at the Yale School of Medicine who is working on the project.

“If our ongoing clinical trials validate the preclinical findings reported in this article and ultrasound can be used to lower insulin and glucose levels, ultrasound neuromodulation will be an interesting and entirely new addition to our patients’ existing treatment options.”

The study found that just three minutes of focused ultrasound each day was enough to maintain normal blood glucose levels in diabetic animals. Human studies are currently underway to find out how this method matches the results of animal studies. But there are other obstacles to the widespread clinical application of the method, in addition to simply proving its effectiveness.

The current ultrasonic instruments used to perform this kind of pFUS require skilled technicians. The researchers suggest that technology exists to simplify and automate these systems so that they can be used by patients at home, but it needs to be developed before this treatment is widely adopted.

“… Wearable ultrasound sensors have minimized the need for manual handling of the transducer during use, and automated anatomical target detection software is now available to track targets in real time using convolutional neural network models,” the researchers write in a new paper.

“These advances may enable the development of new wearable ultrasound systems that can be used by non-skilled users and further enable their use in a variety of clinical applications and settings.”

Of course, it’s important to note that this study was funded and conducted by researchers at GE Research, the innovation arm of the global energy company General Electric. So if anyone has the resources to develop some small, directional ultrasound device for use at home as a treatment for diabetes, it’s this company.

Christopher Pouleo, corresponding author of the new study and senior biomedical engineer at GE Research, says these new non-drug approaches could replace a number of drugs in the future.

“We are now in the process of human trials with a cohort of type 2 diabetics, which will allow us to begin work on clinical applications,” Pouleo said. “The use of ultrasound may in the future change the way bioelectronic drugs are used and used to treat diseases such as type 2 diabetes.”

Other researchers are somewhat more cautious in interpreting these new results. In a commentary on the study, the editors of the journal Nature Biomedical Engineering acknowledged that this innovation could eventually lead to a new kind of treatment for diabetes, but much more work needs to be done.

“That focused ultrasound pulses applied to the hepatoportal plexus can restore glucose homeostasis, as shown by the authors in various animal models, highlights the therapeutic value of the brain-liver neural pathways and may ultimately become an alternative non-invasive treatment for type 2 diabetes and others.” metabolic disease,” the editors wrote in a statement accompanying the new publication. “This approach deserves further testing in larger animals.”

Richard Benninger, a diabetes researcher at the Anshut University of Colorado Medical Campus, called the new work an extremely thorough demonstration of how ultrasound can be used to treat diabetes.

“The authors provide a detailed characterization of how hyperglycemia regresses in numerous peripheral and central tissues in different animal models,” said Benninger, who did not work on the new study. “This approach represents a new paradigm for diabetes management, and the ability to use ultrasound means it can be easily translated into other languages.”

Of course, the positive results of early animal studies may mean that real clinical applications are still years away.

The GE Research team reported that further preclinical studies have been conducted that have examined different doses and durations of ultrasound. The first human studies have also begun, with preliminary results expected later this year.

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