A system for treating a patient with impaired glucose regulation comprising: at least two electrodes (212, 212a) operably connected to an implantable pulse generator, wherein the first electrode and the second electrode are adapted to be placed on a vagus nerve below a vagal innervation of the heart; the implantable pulse generator comprising a power module and a programmable therapy delivery module, wherein the programmable therapy delivery module is configured to deliver a first therapy program to the first electrode and the second electrode comprising an electrical signal treatment, wherein the programmable therapy delivery module is configured to apply a bi-polar, bi-phasic electrical signal to the at least two electrodes, and is configured to apply said electrical signal intermittently multiple times in a day, and is configured to apply said electrical signal over multiple days to the vagus nerve, wherein the electrical signal treatment has a frequency selected to down regulate activity on the vagus nerve, wherein the frequency of the electrical signal is 500-5000 Hz, and has an on time and an off time, wherein the off time is selected to allow at least a partial recovery of the activity of the vagus nerve; and an external component comprising an antenna and a programmable storage and communication module, wherein said programmable storage and communication module is configured to store the at least one first therapy program and to communicate the at least one first therapy program to the implantable pulse generator, wherein the system is configured to allow adjustment of the signal parameters of the at least one first therapy program; and wherein said system further comprises a blood glucose sensor. at least two electrodes (212, 212a) operably connected to an implantable pulse generator, wherein the first electrode and the second electrode are adapted to be placed on a vagus nerve below a vagal innervation of the heart; the implantable pulse generator comprising a power module and a programmable therapy delivery module, wherein the programmable therapy delivery module is configured to deliver a first therapy program to the first electrode and the second electrode comprising an electrical signal treatment, wherein the programmable therapy delivery module is configured to apply a bi-polar, bi-phasic electrical signal to the at least two electrodes, and is configured to apply said electrical signal intermittently multiple times in a day, and is configured to apply said electrical signal over multiple days to the vagus nerve, wherein the electrical signal treatment has a frequency selected to down regulate activity on the vagus nerve, wherein the frequency of the electrical signal is 500-5000 Hz, and has an on time and an off time, wherein the off time is selected to allow at least a partial recovery of the activity of the vagus nerve; and an external component comprising an antenna and a programmable storage and communication module, wherein said programmable storage and communication module is configured to store the at least one first therapy program and to communicate the at least one first therapy program to the implantable pulse generator, wherein the system is configured to allow adjustment of the signal parameters of the at least one first therapy program; and wherein said system further comprises a blood glucose sensor.