An implantable, wirelessly powered electronic device could offer a drug-free approach to managing the intertwined metabolic disorders of obesity and type 2 diabetes. The device uses electrocatalysis to remove excess glucose from the bloodstream on demand. Obesity and diabetes are closely interconnected metabolic disorders that reinforce one another through complex hormonal, inflammatory, and energy-regulation processes, together contributing to the global rise of “diabesity.” Existing treatments rely heavily on long-term medication and lifestyle changes, while current glucose-monitoring and insulin-delivery systems face limitations in accuracy, reliability, personalization, and cost. Emerging approaches, including engineered therapeutic cells and drugs that target both weight and blood glucose, offer promise but remain constrained by concerns of side effects, safety, and affordability. Another emerging strategy involves electrocatalysis, which uses electrode surfaces to drive chemical reactions that convert glucose into other compounds.

Using electrocatalysis, Debasis Maity and colleagues developed an implantable device called electrocatalytic closed-loop health optimization (ECHO). The wirelessly powered device uses a platinum-decorated gold catalyst to convert circulating glucose into gluconate, which can be excreted through the kidneys. Connected to a continuous glucose monitor via a smartphone, ECHO automatically activates when blood sugar exceeds a preset threshold, enabling targeted glucose removal without external insulin or medication. In a proof-of-concept study in obese mice with type 2 diabetes, Maity et al. report that wireless activation of the device at low power (0.75 volts and 10 milliamperes) restored normal blood glucose levels within an hour and shifted the body’s energy use from glucose toward fat. Over six weeks of treatment, the mice experienced reductions in body weight and triglyceride levels, alongside increases in circulating free fatty acids and ketone bodies. These changes occurred without detectable episodes of low blood sugar or adverse effects on physiological function, inflammation, or behavior. “Current bioelectronics devices provide notable access to the nervous and neuromuscular systems,” write William Bentley and Gregory Payne in a related Perspective. “Therefore, future electronic intervention devices might help to manage diseases other than diabetes, modulate human-microbiome interactions, or maintain redox homeostasis in stress conditions, among many other applications.”