Journal of Thyroid Disorders & Therapy
Open Access
ISSN: 2167-7948
+44 1300 500008
ISSN: 2167-7948
+44 1300 500008
Jonathan J Waataja
ReShape Lifesciences, USA
Scientific Tracks Abstracts: Thyroid Disorders Ther
Statement of the Problem: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become the gold standard for the treatment of type 2 diabetes mellitus (T2DM). However, the therapeutic benefits of GLP-1 are marred by compliance, cost, and side effects. In real-world studies discontinuation rates of GLP-1 RAs is 45% following 1 year of therapy. Vagus nerve modulation is a novel methodology for treating T2DM. Neuromodulation consisting of stimulation of celiac fibers innervating the pancreas w/ simultaneous reversible electrical blockade of neuronal hepatic fibers innervating the liver is new therapeutic concept that that we have successfully tested in animal models of T2DM. Here we present a summary of results utilizing an alloxan treated swine model of T2DM that demonstrates that block and stimulation increase glycemic control by improving 3 disease metrics; decreased fasting plasma glucose (FPG), increased performance on glucose tolerance tests, and decreasing variability of plasma glucose during glucose tolerance tests. Methodology & Theoretical Orientation: Experiments were conducted on an alloxan treated swine model of T2DM model. (n=6). During Oral Glucose Tolerance Tests (OGTTs) area under the curve (AUC) and %coefficient of variation (%CV) were calculated. Block and stimulation were applied during the OGTTs. Measurements of FPG were taken following multiple applications of block and stimulation The blocking signal consisted of application of 5000 Hz alternating current and stimulation was at 1 Hz. The neuromodulation system was fully implanted during these chronic studies. Findings: Block and stimulation decreased FPG from167±15 mg/dL to 69±2 (p<0.01). The AUC of OGTTs significantly decreased by 60±11% (p<0.05) and glucose variability decreased from an average of 67±18% to 12±2% (P<0.01). Conclusion & Significance: There are many possible mechanisms behind block and stimulation increasing glycemic control in this study, shown in figure 1. Regardless of mechanisms, multi-site multi-frequency neuromodulation offers a multitude of different therapy parameters for targeted personalized medicine.
Waataja received his PhD in neuroscience at the University of Minnesota investigating cellular mechanisms of synaptic degeneration. Following a post-doctoral fellowship in chronic pain and spinal cord electrophysiology, he joined ReShape Lifesciences to pursue research into vagus neuromodulation as a treatment for metabolic diseases such as type 2 diabetes.