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Abstract
Objectives A new generation of neuromuscular electrical stimulation (NMES) devices can exercise aerobically at equivalent rates to voluntary exercise. Many with type 2 diabetes cannot or will not exercise sufficiently. The objective of this pilot investigation was to see (1) if it was an acceptable training modality for men with type 2 diabetes mellitus and (2) to assess effects on haemoglobin A1c levels.
Design, setting, participants and intervention A case series of eight men with type 2 diabetes mellitus (aged 53±8; body mass index 32±5 5 kg/m2) trained with the NMES system for 1 h 6 times weekly for 8 weeks, unsupervised, at home. There were no other medication or lifestyle interventions. The aerobic NMES exercise system delivers a repeating set of four complex staggered pulses at high intensities (typically 100 mA+) through an array of eight thigh electrodes.
Outcome measures The primary outcome measures were changes in haemoglobin A1c and the responses in a questionnaire on participants' perceptions of the system. Body mass and composition were also measured before and after the NMES intervention period.
Results All participants could use the system at a level that left them breathless and sweaty and with a heart rate over 120 beats per minute. Haemoglobin A1c levels improved by 0.8±0.7% from 7.4±1.3% (mean ± SD) to 6.6±1.0% (p=0.01). All participants considered the system suitable for people with diabetes, would recommend it and would continue to use it twice a week ‘to maintain improvements’.
Conclusions These results suggest that aerobic NMES may be acceptable and have a beneficial effect on haemoglobin A1c of some men with diabetes. The treatment may be of particular benefit in those who will not or cannot do adequate amounts of voluntary exercise. A randomised control trial is required for conclusive efficacy data.
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Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
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- Data supplement 1 - Online table 1
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Footnotes
To cite: Crowe L, Caulfield B. Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study. BMJ Open 2012;2:e000219. doi:10.1136/bmjopen-2011-000219
Contributors LC developed the technology (with BMR Ltd who designed and provided the stimulation platform and software) and parameters, tested the subjects and wrote the paper. BC was responsible for obtaining institutional ethics clearance, contributed to the study design, assisted with the study's implementation and revised the paper. Both authors approved the final version.
Funding Enterprise Ireland. (An Irish governmental body). Funding for a university-based project investigating NMES.
Competing interests None.
Ethics approval Ethics approval was provided by UCD Human Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The NMES parameters used to induce a large aerobic effect are non-standard and quite intricate. The normal NMES nomenclature and descriptions are not applicable to much of it. A lot of the detail has been included in the article but we invite research groups to contact us for full details, explanation, etc.