Gi and pancreatic device for treating obesity and diabetes

Abstract

A method is provided, including placing first and second electrodes at respective first and second sites of a duodenum of a subject, and activating the electrodes to increase a blood insulin level of the subject. Other embodiments are also described.

1 - 8 . (canceled)  
   
   
       9 . Apparatus comprising: 
 one or more electrodes, adapted to be placed in contact with a wall of a lumen of a duodenum of a subject;    a control unit, adapted to drive the electrodes to apply a current to the wall of the duodenal lumen, and to configure the current to stimulate a site selected from the group consisting of: a vagus nerve of the subject, and enteric nervous system (ENS) tissue of the subject.    
   
   
       10 . The apparatus according to  claim 9 , wherein the site includes the vagus nerve of the subject, and wherein the control unit is adapted to configure the current to stimulate the vagus nerve.  
   
   
       11 . The apparatus according to  claim 9 , wherein the site includes the ENS tissue of the subject, and wherein the control unit is adapted to configure the current to stimulate the ENS tissue.  
   
   
       12 . The apparatus according to  claim 9 , wherein the control unit is adapted to be placed in a gastrointestinal tract of the subject.  
   
   
       13 . The apparatus according to  claim 12 , wherein the control unit is adapted to be placed in a stomach of the subject.  
   
   
       14 . The apparatus according to  claim 12 , wherein the control unit is adapted to be implanted in the subject outside of the stomach, and to be wirelessly coupled to the electrodes.  
   
   
       15 . The apparatus according to  claim 12 , wherein the control unit is adapted to be implanted in the subject outside of the stomach, and wherein the apparatus comprises wires configured to couple the control unit to the electrodes.  
   
   
       16 . The apparatus according to  claim 12 , wherein the control unit is adapted to be placed outside of a body of the subject, and to be wirelessly coupled to the electrodes.  
   
   
       17 . Apparatus comprising: 
 an eating sensor, adapted to be placed in a body of a subject, and to generate a signal indicative of eating by the subject;    a stimulator adapted to stimulate a site selected from the group consisting of: a vagus nerve of the subject and enteric nervous system (ENS) tissue of the subject, and adapted to be placed in a gastrointestinal tract of the subject;    one or more electrodes, adapted to be implanted at respective duodenal sites of the subject; and    a control unit, adapted to receive the eating signal, and, responsively thereto, to drive the stimulator to apply a first current to the selected site of the subject, and to drive the one or more electrodes to apply a second current that modulates activity of pancreatic beta cells of the subject.    
   
   
       18 . The apparatus according to  claim 17 , wherein the control unit is adapted to set the first current to have a frequency equal to at least 3 times a frequency of the second current.  
   
   
       19 . The apparatus according to  claim 17 , comprising an intragastric balloon, adapted to be placed in a stomach of the subject.  
   
   
       20 . The apparatus according to  claim 19 , wherein the intragastric balloon comprises the eating sensor.  
   
   
       21 - 23 . (canceled)  
   
   
       24 . A method comprising: 
 inserting one or more helical electrodes into a duodenum of a subject; expanding the one or more electrodes to establish electrical contact between the one or more electrodes and a wall of the duodenum;    driving a current through the one or more electrodes; and configuring the current to induce a contraction of the duodenum.    
   
   
       25 . A method comprising: 
 inserting a stent comprising one or more electrodes into a duodenum of a subject; driving a current through the one or more electrodes; and    configuring the current to induce a contraction of the duodenum.    
   
   
       26 . A method comprising: 
 driving a current into a duodenal site of a subject; and configuring the current to enhance satiety of the subject by stimulating enteric nervous system (ENS) tissue of the subject.    
   
   
       27 . A method comprising: 
 driving a current into a duodenal site of a subject; and configuring the current to enhance satiety of the subject by elevating a blood level of cholecystokinin (CCK) of the subject.    
   
   
       28 . A method comprising: 
 driving a current into a duodenal site of a subject; and configuring the current to enhance satiety of the subject by elevating a blood level of GLP-1 of the subject.    
   
   
       29 . A method comprising: 
 placing first and second electrodes at respective first and second sites of a duodenum of a subject; and activating the electrodes to increase a blood insulin level of the subject.    
   
   
       30 . The method according to  claim 29 , wherein placing comprises placing the electrodes such that a straight line connecting the electrodes passes through a pancreas of the subject.  
   
   
       31 . The method according to  claim 29 , comprising sensing an indication of the subject having eaten a meal, and activating the electrodes responsively thereto.  
   
   
       32 . The method according to  claim 29 , wherein placing comprises placing the first and second electrodes at least 5 cm apart.  
   
   
       33 . The method according to  claim 32 , wherein activating the electrodes comprises applying a signal having an amplitude between 2 mA and 8 mA, and a frequency between 3 Hz and 20 Hz.  
   
   
       34 . The method according to  claim 33 , wherein applying the signal comprises (a) applying the signal for less than 5 seconds, (b) withholding the signal for greater than 10 seconds, and (c) cycling between (a) and (b).  
   
   
       35 . The method according to  claim 29 , comprising driving a current into the duodenum configured to induce satiety in the subject.  
   
   
       36 . The method according to  claim 35 , wherein driving the current comprises delaying gastric emptying.  
   
   
       37 . The method according to  claim 35 , wherein driving the current comprises configuring the current to induce afferent vagal signaling that reduces eating by the subject.  
   
   
       38 . The method according to  claim 29 , comprising driving a current into the duodenum configured to induce contraction of the duodenum.  
   
   
       39 . The method according to  claim 38 , wherein driving the current comprises configuring the current to induce peristalsis.  
   
   
       40 . The method according to  claim 38 , wherein driving the current comprises increasing a rate of peristalsis.  
   
   
       41 . The method according to  claim 38 , wherein driving the current comprises configuring the current to induce at least one migratory motor complex (MMC).  
   
   
       42 . The method according to  claim 41 , comprising timing the driving of the current such that the MMC occurs at a time earlier than a natural time of MMC occurrence.  
   
   
       43 - 46 . (canceled)  
   
   
       47 . A method, comprising: 
 driving a current between first and second electrodes at respective first and second sites, spaced by at least 5 mm, of a duodenum of a subject; and    configuring the current to stimulate tissue in a longitudinal muscle layer of the duodenum.    
   
   
       48 . A method, comprising: 
 driving a current between first and second electrodes at respective first and second sites, spaced by less than 5 mm, of a duodenum of a subject; and    configuring the current to stimulate tissue in a circular muscle layer of the duodenum.    
   
   
       49 . Apparatus, comprising: 
 a capsule adapted to be swallowed by a subject; a sensor, adapted to be implanted within the subject, to detect proximity of the capsule to the sensor, and to generate a sensor signal responsively thereto; and a treatment unit, adapted to apply a treatment to the subject in response to receiving the sensor signal.    
   
   
       50 . The apparatus according to  claim 49 , wherein the capsule comprises a magnet.  
   
   
       51 - 53 . (canceled)