Perspective chapter: Exploring the Potential of Vagus Nerve Neuromodulation as a Personalized and Enhanced Therapeutic Experience for Type 2 Diabetics

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists have become the gold standard for the treatment of type 2 diabetes mellitus (T2D). The therapeutic benefits of GLP-1 are marred by compliance, cost, and side effects. Vagus nerve modulation (VNM) holds great potential for current and future neuromodulation therapies in a range of medical conditions. Treatment for T2D using VNM is a potential new area of research. Most VNM studies investigating glycemic control utilize glucose tolerance tests. There are few long-term chronic studies examining both fasting plasma glucose and plasma glucose in the absorptive state. This chapter explores literature involving the use of VNM to enhance glycemic control. Also, results of a novel method of multi-site, multi-frequency sub-diaphragmatic vagal neuromodulation will be reviewed as well as a discussion of mechanisms associated with this VNM technique. This modality holds promise in enhancing glycemic control in the fasting and postprandial states. Multi-site multi-frequency neuromodulation offers a multitude of different therapy parameters for personalized medicine.