Neuromuscular electrostimulation and insulin sensitivity in patients with type 2 diabetes: the ELECTRODIAB pilot study

• Published in: Acta diabetologica 2015-04, Vol.52 (2), p.285-291
• Main Authors: Joubert, Michael, Metayer, Laure, Prevost, Gaetan, Morera, Julia, Rod, Anne, Cailleux, Anne, Parienti, Jean-Jacques, Reznik, Yves
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Diabetes; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - therapy; Electric Stimulation Therapy; Energy Metabolism; Female; Humans; Insulin; Insulin - metabolism; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Motor Activity; Muscle, Skeletal - metabolism; Muscle, Skeletal - physiopathology; Neuromuscular diseases; Original Article; Pilot Projects; Prospective Studies; Studies; Young Adult
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-014-0636-5

Aim Physical activity (PA) improves insulin sensitivity and is particularly important for type 2 diabetes (T2D) management; however, patient adherence is poor. Neuromuscular electrostimulation (NMES) is widely used for rehabilitation issues, but the metabolic impact of provoked involuntary muscular contractions has never been investigated. Materials and methods ELECTRODIAB is a prospective, bi-centric, and 4-week-long pilot study that enrolled 18 patients with T2D who did not require insulin treatment. Insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp before and after (1) a single NMES session and (2) a week of daily NMES training. Energy expenditure (EE) at baseline and during NMES was evaluated by indirect calorimetry. Dietary and background PA were monitored to avoid bias. Results After a single session (T1) or a week (T2) of NMES training, insulin sensitivity ( M value) increased by 9.3 ± 38.2 % (ns) and 24.9 ± 35.8 % ( p  = 0.009), respectively, compared with the baseline (T0). Insulin sensitivity increased up to 46.2 ± 33.8 % ( p  = 0.002) at T2 in the more insulin-resistant subjects (baseline M value ≤4 mg/Kg/min, n  = 10). The NMES session-generated EE was 1.42 ± 9.27 kcal/h, which was not significantly increased from the baseline. Conclusions Insulin sensitivity was significantly improved in patients with T2D after 1 week of daily NMES training, with very low EE. NMES could be an alternative to conventional PA, but the putative mechanisms of action must still be investigated.