Wirelessly Powered Electronic Implant, ECHO, Enables Drug-Free Management of ‘Diabesity’

Researchers at ETH Zürich, the University of Lyon, and the University of Basel have developed an implantable, wirelessly powered electronic device, known as ECHO, (electrocatalytic closed-loop health optimization)  that could offer a drug-free approach to managing obesity and type 2 diabetes (T2D). These two interlinked metabolic disorders often coexist—as “diabesity”—affecting billions of people worldwide.

The team’s implantable device uses electrocatalysis to remove excess glucose from the bloodstream on demand. Tested in a diabesity mouse model, the device was coupled to a continuous glucose monitor (CGM) via a smartphone, enabling autonomous closed-loop metabolic control, such that the electrocatalyst was only activated when glucose levels exceeded a predefined threshold. The results showed that the device rapidly restored elevated blood glucose level to the normal range, with repeated treatments maintaining glucose control for weeks, without any drug use. Lowering glucose also shifted whole-body metabolism toward the use of stored fat, so treated mice also demonstrated reduced body weight.

Research lead Martin Fussenegger, PhD, a professor at the Department of Biosystems Science and Engineering, ETH Zürich, is senior and corresponding author of the team’s published paper in Science Advances, titled “Wireless electrocatalytic closed-loop system for drug-free management of diabesity.” In their report the team wrote in summary, “We believe that closed-loop electrocatalytic devices could establish a platform concept for regulating disease-relevant metabolites, offering a potential route toward drug-sparing, dynamically controlled metabolic interventions.”

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. “The physiological relationship between obesity and diabetes is bidirectional and self-reinforcing, involving a complex interplay of metabolic, hormonal, and inflammatory changes,” the authors explained. 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. “Current treatments rely largely on drugs that lower blood glucose or body weight, but these therapies can produce side effects, require lifelong administration, and may lose effectiveness over time,” the authors continued.

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. “A subcutaneous implant containing a solid electrocatalyst that directly removes excess glucose from the bloodstream at an electrically adjustable rate could provide a dose-controllable, drug-free therapeutic alternative.”

Using electrocatalysis, Debasis Maity and colleagues developed the implantable ECHO device. The wirelessly powered device uses a platinum (Pt)-decorated gold (Au) nanoclusters embedded in a porous, conductive graphite felt (GF) matrix. The electrocatalyst converts circulating glucose into gluconate, which can be excreted through the kidneys.

Connected via smartphone to a continuous glucose monitor, ECHO automatically activates when blood sugar exceeds a predetermined threshold, enabling targeted glucose removal without the need for external insulin or medication.

In a proof-of-concept study in obese mice with type 2 diabetes, the authors showed 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.

“The CGM system tracked glucose concentrations and transmitted the data to a smartphone, which processed the data and sent instructions back to the ECHO device, which in turn rapidly adjusted glucose concentrations to maintain homeostasis in response—achieving this without hypoglycemic episodes or the need for small-molecule drugs or biopharmaceuticals,” the authors wrote.

In a related perspective, William Bentley, PhD, and Gregory Payne, PhD, at the Fischell Department of Bioengineering, University of Maryland, wrote, “Existing bioelectronics devices provide notable access to the nervous and neuromuscular systems … 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.”

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