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Erschienen in: Acta Diabetologica 5/2016

14.05.2016 | Original Article

Enhanced external counterpulsation (EECP) improves biomarkers of glycemic control in patients with non-insulin-dependent type II diabetes mellitus for up to 3 months following treatment

verfasst von: Paloma D. Sardina, Jeffrey S. Martin, Joseph C. Avery, Randy W. Braith

Erschienen in: Acta Diabetologica | Ausgabe 5/2016

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Abstract

Aims

The purpose of the present study was to evaluate the potential clinical benefits of EECP on glycemic parameters [fasting plasma glucose (FPG), postprandial glucose (PPG120), glycosylated hemoglobin (HbA1c)] in patients with a clinical diagnosis of type II diabetes mellitus (T2DM).

Methods

Thirty subjects (60.7 ± 1.9 years) with T2DM were randomly assigned (2:1 ratio) to receive either 35 1-h sessions of EECP (n = 20) or time-matched control of standard care (n = 10). FPG, PPG120, and HbA1c were evaluated before and at 48 h, 2 weeks, 3 and 6 months following EECP treatment or time-matched control.

Results

EECP significantly decreased FPG (−14.6 and −12.0 %), PPG120 (−14.6 and −13.5 %), and HbA1c (−11.5 and −19.6 %) 48 h following EECP and 2 weeks following EECP, respectively. HbA1c remained significantly reduced at 3 months following EECP (−14.3 %). The homeostasis model assessment of insulin resistance (−31.1 %) and whole-body composite insulin sensitivity index (+54.2 %) were significantly improved 48 h following EECP. Nitrite/nitrate (NO x ) was significantly increased 48 h following EECP (+48.4 %) and 2 weeks (+51.9 %) following EECP treatment.

Conclusions

Our findings provide novel evidence that EECP improves glycemic control in patients with T2DM that persist for up to 3 months following treatment.
Literatur
1.
Zurück zum Zitat Centers for Disease Control and Prevention (2014) National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: US Department of Health and Human Services Centers for Disease Control and Prevention (2014) National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: US Department of Health and Human Services
2.
Zurück zum Zitat World Health Organization (2006) Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of World Health Organization/International Diabetes Federation consultation. WHO Document Production Services World Health Organization (2006) Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of World Health Organization/International Diabetes Federation consultation. WHO Document Production Services
3.
Zurück zum Zitat Rubin R (2005) Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med 118:27S–34SCrossRefPubMed Rubin R (2005) Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med 118:27S–34SCrossRefPubMed
4.
Zurück zum Zitat Monami M, Ragghianti B, Zannoni S, Vitale V, Nreu B, Mannucci E (2016) Identification of predictors of response to basal insulin and DPP4 inhibitors in patients with type 2 diabetes failing to other therapies. Acta Diabetol 53(1):35–40CrossRefPubMed Monami M, Ragghianti B, Zannoni S, Vitale V, Nreu B, Mannucci E (2016) Identification of predictors of response to basal insulin and DPP4 inhibitors in patients with type 2 diabetes failing to other therapies. Acta Diabetol 53(1):35–40CrossRefPubMed
5.
Zurück zum Zitat Rys P, Wojciechowski P, Rogoz-Sitek A et al (2015) Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus. Acta Diabetol 52(4):649–662CrossRefPubMedPubMedCentral Rys P, Wojciechowski P, Rogoz-Sitek A et al (2015) Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus. Acta Diabetol 52(4):649–662CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Klip A (2009) The many ways to regulate glucose transporter 4. Appl Physiol Nutr Metab 34(3):481–487CrossRefPubMed Klip A (2009) The many ways to regulate glucose transporter 4. Appl Physiol Nutr Metab 34(3):481–487CrossRefPubMed
8.
Zurück zum Zitat Hong Y, Betik A, McConell G (2014) Role of nitric oxide in skeletal muscle glucose uptake during exercise. Exp Physiol 99(12):1569–1573CrossRefPubMed Hong Y, Betik A, McConell G (2014) Role of nitric oxide in skeletal muscle glucose uptake during exercise. Exp Physiol 99(12):1569–1573CrossRefPubMed
9.
Zurück zum Zitat Tao J, Tu C, Yang Z et al (2006) Enhanced external counterpulsation improves endothelium-dependent vasorelaxation in the carotid arteries of hypercholesterolemic pigs. Int J Cardiol 112(3):269–274CrossRefPubMed Tao J, Tu C, Yang Z et al (2006) Enhanced external counterpulsation improves endothelium-dependent vasorelaxation in the carotid arteries of hypercholesterolemic pigs. Int J Cardiol 112(3):269–274CrossRefPubMed
10.
Zurück zum Zitat McConell G, Rattigan S, Lee-Young R, Wadley G, Merry T (2012) Skeletal muscle nitric oxide signaling and exercise: a focus on glucose metabolism. Am J Physiol Endcrinol Metab 303(3):E301–E307CrossRef McConell G, Rattigan S, Lee-Young R, Wadley G, Merry T (2012) Skeletal muscle nitric oxide signaling and exercise: a focus on glucose metabolism. Am J Physiol Endcrinol Metab 303(3):E301–E307CrossRef
11.
Zurück zum Zitat Gurovich A, Braith RW (2012) Enhanced external counterpulsation creates acute blood flow patterns responsible for improved flow-mediated dilation in humans. Hypertens Res 36(4):297–305CrossRefPubMed Gurovich A, Braith RW (2012) Enhanced external counterpulsation creates acute blood flow patterns responsible for improved flow-mediated dilation in humans. Hypertens Res 36(4):297–305CrossRefPubMed
12.
Zurück zum Zitat Braith R, Conti C, Nichols W et al (2010) Enhanced external counterpulsation improves peripheral artery flow-mediated dilation in patients with chronic angina: a randomized sham-controlled study. Circulation 122(16):1612–1620CrossRefPubMedPubMedCentral Braith R, Conti C, Nichols W et al (2010) Enhanced external counterpulsation improves peripheral artery flow-mediated dilation in patients with chronic angina: a randomized sham-controlled study. Circulation 122(16):1612–1620CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Beck D, Martin J, Casey D, Avery J, Sardina P, Braith R (2014) Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischemic left ventricular dysfunction. Clin Exp Pharmacol Physiol 41(9):628–636PubMedPubMedCentral Beck D, Martin J, Casey D, Avery J, Sardina P, Braith R (2014) Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischemic left ventricular dysfunction. Clin Exp Pharmacol Physiol 41(9):628–636PubMedPubMedCentral
14.
Zurück zum Zitat Martin J, Beck D, Aranda J, Braith R (2012) Enhanced external counterpulsation improves peripheral artery function and glucose tolerance in subjects with abnormal glucose tolerance. J Appl Physiol 112(5):868–876CrossRefPubMed Martin J, Beck D, Aranda J, Braith R (2012) Enhanced external counterpulsation improves peripheral artery function and glucose tolerance in subjects with abnormal glucose tolerance. J Appl Physiol 112(5):868–876CrossRefPubMed
15.
Zurück zum Zitat Pannala A, Mani A, Spencer J et al (2003) The effect of dietary nitrate on salivary, plasma, and urinary nitrate metabolism in humans. Free Radic Biol Med 34:576–584CrossRefPubMed Pannala A, Mani A, Spencer J et al (2003) The effect of dietary nitrate on salivary, plasma, and urinary nitrate metabolism in humans. Free Radic Biol Med 34:576–584CrossRefPubMed
16.
Zurück zum Zitat Matsuda M, DeFronzo R (1999) Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 22:1462–1470CrossRefPubMed Matsuda M, DeFronzo R (1999) Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 22:1462–1470CrossRefPubMed
17.
Zurück zum Zitat Bonora E (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 23(1):57–63CrossRefPubMed Bonora E (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 23(1):57–63CrossRefPubMed
18.
Zurück zum Zitat Cavalot F, Pagliarino A, Valle M et al (2011) Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 34(10):2237–2243CrossRefPubMedPubMedCentral Cavalot F, Pagliarino A, Valle M et al (2011) Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 34(10):2237–2243CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Chen Y, Lin Y, Chong E et al (2015) The impact of diabetes mellitus and corresponding HbA1c levels on the future risks of cardiovascular disease and mortality: a representative cohort study in Taiwan. PLoS One 10(4):e0123116CrossRefPubMedPubMedCentral Chen Y, Lin Y, Chong E et al (2015) The impact of diabetes mellitus and corresponding HbA1c levels on the future risks of cardiovascular disease and mortality: a representative cohort study in Taiwan. PLoS One 10(4):e0123116CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Davies P (2009) Hemodynamic shear stress and the endothelium in cardiovascular pathophysiology. Nat Clin Pract Cardiovasc Med 6(1):16–26CrossRefPubMed Davies P (2009) Hemodynamic shear stress and the endothelium in cardiovascular pathophysiology. Nat Clin Pract Cardiovasc Med 6(1):16–26CrossRefPubMed
21.
Zurück zum Zitat Zhang Y, He X, Chen X et al (2007) Enhanced external counterpulsation inhibits hyperplasia by modifying shear stress responsive gene expression in hypercholesteremic pigs. Circulation 116:526–534CrossRefPubMed Zhang Y, He X, Chen X et al (2007) Enhanced external counterpulsation inhibits hyperplasia by modifying shear stress responsive gene expression in hypercholesteremic pigs. Circulation 116:526–534CrossRefPubMed
Metadaten
Titel
Enhanced external counterpulsation (EECP) improves biomarkers of glycemic control in patients with non-insulin-dependent type II diabetes mellitus for up to 3 months following treatment
verfasst von
Paloma D. Sardina
Jeffrey S. Martin
Joseph C. Avery
Randy W. Braith
Publikationsdatum
14.05.2016
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 5/2016
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-016-0866-9

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