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

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Abstract

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.

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Acknowledgements

M.J. designed the trial, performed research, and wrote the manuscript. L.M. performed research. G.P. performed research and reviewed/edited the manuscript. J.M. performed research. A.R. performed research. A.C. performed research. J.J.P. designed the trial and reviewed/edited the manuscript. Y.R. performed research, contributed to discussion, and reviewed/edited the manuscript. The authors thank all investigators, study teams, and patients for participating in this study. The authors acknowledge Sylvie Brucato, Caroline Serre, and Laure Allain from the clinical research center of Caen University Hospital for their assistance throughout this study. The authors also acknowledge Pascal Adam (DJO company) for his technical assistance with electrostimulation devices. This study was supported by a grant from the French Ministry of Health (PHRC 2011 API06-01). The electrostimulation devices were provided gratis by DJO (Vista, CA, USA). All researchers have declared no conflicts of interest with regard to this company, which did not play any role in the study design, data collection, and analysis or in the publication submission. Previously, this study was partially presented in abstract form at the 49th Annual EASD Meeting, Barcelona, Spain, September 23–27, 2013.

Conflict of interest

Michael Joubert, Laure Metayer, Gaetan Prevost, Julia Morera, Anne Rod, Anne Cailleux, Jean-Jacques Parienti and Yves Reznik declare that they have no conflict of interest.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (ethical committee North-West III, France) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Diabetes Care Unit, University Hospital of Caen, Caen, France

    Michael Joubert, Laure Metayer, Julia Morera, Anne Rod & Yves Reznik

  2. Diabetes Care Unit, University Hospital of Rouen, Rouen, France

    Gaetan Prevost

  3. Institut National de la Santé et de la Recherche Médicale (INSERM) CIC 0204, Institut de Recherche et d’Innovation Biomédicale, Normandie Univ, 76031, Rouen, France

    Gaetan Prevost & Anne Cailleux

  4. Biostatistic and Clinical Research Unit, University Hospital of Caen, Caen, France

    Jean-Jacques Parienti

  5. University of Caen Basse-Normandie, Caen, France

    Julia Morera, Jean-Jacques Parienti & Yves Reznik

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  1. Michael Joubert
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Correspondence to Michael Joubert.

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Joubert, M., Metayer, L., Prevost, G. et al. Neuromuscular electrostimulation and insulin sensitivity in patients with type 2 diabetes: the ELECTRODIAB pilot study. Acta Diabetol 52, 285–291 (2015). https://doi.org/10.1007/s00592-014-0636-5

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  • DOI: https://doi.org/10.1007/s00592-014-0636-5

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