title: Neuromuscular electrostimulation and insulin sensitivity in patients with type 2 diabetes: the ELECTRODIAB pilot study.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Diabetes Care Unit, University Hospital of Caen, Caen, France, joubert-m@chu-caen.fr.
authors.forename: Michael
authors.initials: M
authors.lastname: Joubert
authors.forename: Laure
authors.initials: L
authors.lastname: Metayer
authors.forename: Gaetan
authors.initials: G
authors.lastname: Prevost
authors.forename: Julia
authors.initials: J
authors.lastname: Morera
authors.forename: Anne
authors.initials: A
authors.lastname: Rod
authors.forename: Anne
authors.initials: A
authors.lastname: Cailleux
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Parienti
authors.forename: Yves
authors.initials: Y
authors.lastname: Reznik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000378:metabolism / Q000503:physiopathology*; D010865:Pilot Projects; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D007328:Insulin