Metabolic stress during major surgery can lead to insulin resistance and post-operative hyperglycemia (POHG), potentially impacting patient outcomes. Traditional insulin therapy may not always be effective and could even worsen conditions. A novel approach using non-invasive focused ultrasound stimulation (FUS) of glucose-sensing neurons in the abdomen has shown promise in improving glucose metabolism in diabetic animal models. However, its effectiveness in managing POHG was yet to be explored.
In a recent study, researchers investigated the impact of focused ultrasound neuromodulation on the superior mesenteric plexus (SMP) in altering insulin sensitivity and post-operative hyperglycemia in a swine model of surgical stress-induced POHG. The experiments involved anesthetized animals receiving FUS targeting specific areas, with insulin sensitivity and fasting blood glucose levels monitored before and after the procedures.
The results revealed that SMP-FUS significantly improved insulin sensitivity compared to other targeted areas. Animals treated with SMP-FUS exhibited increased insulin sensitivity on the day of surgery. However, post-surgery, all operated animals experienced mild hyperglycemia, with those receiving SMP-FUS showing higher fasting blood glucose levels compared to sham-treated animals. Interestingly, the study did not establish a clear correlation between changes in insulin sensitivity induced by FUS and subsequent post-operative hyperglycemia.
While the findings suggest that SMP-FUS can enhance insulin sensitivity during surgery, there is a concern that it may exacerbate post-operative hyperglycemia. This highlights the complexity of metabolic responses to neuromodulation interventions and underscores the need for further research to optimize treatment strategies for managing glucose metabolism in surgical settings.
Expert commentary on this study emphasizes the potential of focused ultrasound in modulating neural circuits to influence metabolic processes. The ability to target specific nerve clusters non-invasively opens up new avenues for therapeutic interventions in conditions like POHG. However, the nuanced interplay between neural stimulation and metabolic outcomes underscores the importance of carefully tailored approaches to maximize benefits while minimizing potential risks.
These findings have significant implications for the field of bioelectronic medicine, showcasing the evolving landscape of neuromodulation techniques in addressing metabolic disorders. As research continues to unravel the intricate connections between neural signaling and metabolic function, innovative approaches like focused ultrasound hold promise in revolutionizing treatment modalities for conditions such as POHG.
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