Exploring noninvasive spinal cord neuromodulation for type 2 diabetes: a case series

Type 2 Diabetes Mellitus (T2DM) develops when the pancreas does not secrete sufficient insulin, or when the body is not sufficiently metabolizing blood glucose. WHO estimates 422 million adults live with T2DM worldwide (WHO. Global report on diabetes, 2016). Noninvasive electrical Spinal Cord Neuromodulation (SCONE) is effective in treating sensorimotor and autonomic dysfunctions in adults with paralysis (Gad in J Neurotrauma 35:2145–2158, 2018, Gerasimenko in J Neurotrauma 32:1968–1980, 2015) and children with cerebral palsy (Hastings in Nat Commun 13:5660, 2022). We hypothesize that noninvasive spinal cord neuromodulation can help improve blood glucose control, which is partially regulated by autonomic neural pathways. We conducted a series of first in human case studies to determine the immediate impact of noninvasive SCONE therapy on the blood glucose levels in non-diabetic (n = 2, hba1c < 5.7%), pre-diabetic (n = 2, hbA1c 5.7–6.5%) or Type II diabetic (n = 4, hba1c ≥ 6.5%) individuals (International Expert. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 32(7):1327–34, 2009). We report that 1–2 h of SCONE therapy delivered over the T6/7 and T9/10 vertebral levels resulted in lower blood glucose levels either during the oral glucose tolerance test or immediately following a meal. Multiple days of SCONE therapy further lowered blood glucose levels (2 out of 2) as well as cholesterol levels (1 out of 2) in individuals with T2DM. These preliminary results provide initial clinical evidence of how noninvasive spinal cord neuromodulation could improve blood glucose control in T2DM.