Effect Of Percutaneous Electrical Nerve Field Stimulation on Symptom Control/Nervous System Activity in Patients w/Diabetes Types 1/2

Effect Of Percutaneous Electrical Nerve Field Stimulation (PENFS) On Symptom Control And Autonomic Nervous System Activity In Patients With Diabetes Mellitus

The purpose of this study is to find out if we can stimulate the vagus nerve. The vagus nerve is a largely internal nerve that controls many bodily functions, including stomach function. We hope that electrically stimulating the nerve around the external ear will also stimulate the internal vagus nerve. If it does, then we hope that this will help our treatment of patients with nausea and vomiting and disordered stomach function.

Each participant will be randomized to receive Percutaneous Electrical Nerve Field Stimulation (PENFS) treatment with or without stimulation. The study involves 6 study visits. Study procedures include: removing and replacing the PENFS device, questionnaires, ECG, assessment use of galvanic skin response (GSR), pneumatic belt to assess breathing, physical examine, and blood draws.

Inclusion Criteria:

• Wiling to have one teaspoon (5 ml) of blood drawn.
• Diagnosed with gastroparesis for twelve months or longer
• Diagnosed with diabetes either Type 1 or Type 2
• Documented delayed gastric emptying (>10% retention of the test meal at four hours) on a standardized scrambled-egg scintigraphy gastric emptying test performed in the last two years.
• Upper GI endoscopy indicating no mechanical obstruction performed in the last five years.
• Symptoms of nausea and vomiting consistent with clinical diagnosis of gastroparesis (as opposed to other causes of nausea and vomiting such as mechanical obstruction, acute viral illness, chemotherapy, psychogenic vomiting.
• Documented Hb A1c within three months of screening or at the time of screening (<=8.0)

Exclusion Criteria:

• Unable to provide consent
• Pregnant females
• Medical records indicate intestinal pseudo-obstruction
• Diagnosed with cardiac arrhythmia
• History of prior gastric surgery
• History of vagotomy
• History of organ transplantation
• History of seizures
• Diagnosed with primary swallowing disorders
• Subjects who are dependent on drugs like Marinol for their condition
• Those diagnosed with psychogenic vomiting and not related to gastroparesis
• Medically unstable subjects
• Those at high surgical risk
• Subjects taking narcotic analgesics daily.
• Those with poorly controlled diabetes mellitus (Hgb A1c>8) within three months of screening or at the time of screening.
• Subjects diagnosed with hemophilia, psoriasis vulgaris are excluded
• Those having a cardiac pacemaker will be excluded from the study.