One week of daily training with muscular electrical stimulation improved insulin sensitivity in more than half of patients with type 2 diabetes in a small pilot study, according to data presented at the European Association for the Study of Diabetes annual meeting.
Neuromuscular electrical stimulation (NMES) is defined as high frequency current (100 Hz-150 Hz) applied with transcutaneous electrodes to stimulate motoneurons to induce unintentional muscle contractions.
“We know that adherence to physical activity is rather low in the type 2 diabetic population due to lack of motivation, disabling complications or comorbidities and deconditioning,” Michael Joubert, MD, of the departments of medicine and endocrinology, Caen University Hospital, France, said during a presentation. “NMES could represent an alternative to conventional physical activity, especially in sedentary patients.”
The ELECTRODIAB pilot study consisted of 18 patients who underwent 25 minutes of bi-quadricipital NMES sessions on a daily basis. Patients treated with oral hypoglycemic agents and/or glucagon-like peptide-1 analogs were included, and patients treated with insulin were excluded.
The 1-week training program increased insulin sensitivity by 24.9 ± 35.8% (P=.016), and more than 50% of the patients were considered responders, having an increase in insulin sensitivity of more than 10%. These responders had significantly lower baseline insulin sensitivity.
Joubert said the immediate energy expenditure, measured by indirect calorimetry, was “very low” at just 2%.
“We suggest that this discrepancy between the low energy expenditure and high impact on insulin sensitivity suggests involvement of humoral or endocrine mechanisms,” Joubert said.
Researchers evaluated insulin sensitivity with euglycemic-hyperinsulinemic clamps at baseline, 1 hour after an NMES session and 1 day after the completed week of training. They also monitored physical activity and diet. They reported no serious adverse events, and Joubert said 16 patients wanted to continue long-term treatment.
A follow-up study is ongoing and will look at an ambulatory program of 6-week NMES on glycemic control, Joubert said.
For more information:
Joubert M. Oral presentation #63. Presented at: the 49th Annual Meeting of the European Association for the Study of Diabetes; Sept. 24-27, 2013; Barcelona, Spain.
Disclosure: Joubert reports no relevant financial disclosures.