Review TMS

tDCS as Adjunct in Type 2 Diabetes

Transcranial direct current stimulation modulates central insulin sensitivity and improves adherence to dietary programmes in patients with type 2 diabetes.

Prof. Elena Rossi

Prof. Elena Rossi

Dept. of Clinical Neuroscience, University of Milan · 20 May 2026

photo-1559757175-0eb30cd8c063.jpeg

Key Takeaways

  • Anodal tDCS over the left DLPFC lowers HbA1c in patients with non-intensively treated T2D.
  • Effects appear mediated by improved executive control and appetite regulation.
  • 15-session protocols (2 mA, 20 min) show the best efficacy/tolerability ratio.

Clinical context

Type 2 diabetes is increasingly understood as a brain–metabolic disorder in which prefrontal circuit dysregulation impairs dietary decisions and treatment adherence. tDCS offers a non-invasive approach to modulate these circuits.

Available evidence

Pilot trials published in the last two years document modest but consistent improvements in glycaemia and behavioural adherence, especially when tDCS is combined with structured nutritional counselling.

"tDCS does not replace pharmacotherapy, but can strengthen the patient's ability to maintain lifestyle changes."
— Prof. Elena Rossi, University of Milan

Outlook

Multicentre studies are underway to define maintenance protocols and identify response biomarkers in patients with concurrent T2D and obesity.

References

  1. Marini S. et al. (2025). Anodal tDCS over DLPFC improves glycemic control in T2D: a randomized pilot trial. Diabetes Care, 48(3), 412–419.
  2. Kumar A. et al. (2024). Central insulin sensitivity and tDCS: mechanistic insights from fMRI. Metabolism, 152, 155801.
Prof. Elena Rossi

Prof. Elena Rossi

Full Professor of Clinical Neuroscience at the University of Milan. Director of the BMH Neuromodulation Lab. Her research focuses on non-invasive brain stimulation for metabolic and psychiatric disorders. She has authored over 80 peer-reviewed publications and led 6 multicentre clinical trials.