Neuromuscular electrical stimulation changes glucose, but not its variability in type 2 diabetes: a randomized clinical trial

Neuromuscular electrical stimulation (NMES) can be an alternative to conventional exercising. This randomized clinical trial evaluated the effect of NMES in type 2 diabetes patients. Twenty-eight individuals with type 2 diabetes were assigned to NMES (n=14) or NMES-placebo (n=14) applied to knee extensor muscles for 60 minutes. Glucose variability, microvascular function and endothelial function were evaluated through continuous glucose monitoring system, near infrared spectroscopy and flowmediated dilatation, respectively. Glucose levels (mg/dl) decreased 2h (184 +/- 11 vs 223 +/- 15), 3h (179 +/- 12 vs 219 +/- 14) and 4h (177 +/- 12 vs 212 +/- 12) after NMES, in comparison to NMES-placebo. No differences in glucose variability were found: coefficient of variation (%) at 0-6h (11.4 +/- 1.3 vs 11.4 +/- 1.2), 6-12h (9.8 +/- 1.0 vs 11.6 +/- 1.6), 12-18h (15.5 +/- 2.0 vs 11.4 +/- 2.1), 18-24h (12.8 +/- 2.3 vs 10.0 +/- 1.6); standard deviation (mg/dl) at 0-6h (21.6 +/- 2 vs 24.6 +/- 3.5), 6-12h (19.5 +/- 1.8 vs 20.3 +/- 2.8), 12-18h (29.9 +/- 3.5 vs 21.3 +/- 2.8),18-24h (22.8 +/- 4.1 vs 16.6 +/- 2.0) and mean amplitude of glycemic excursions (mg/dl) 54.9 +/- 25.0 vs 70.3 +/- 35.7. Endothelial and microvascular functions did not change. In conclusion, one acute NMES session was strong enough to trigger glucose reduction in individuals with type 2 DM, but it failed to induce any significant change in glucose variability, endothelial and microvascular functions.