Effect of Neuromuscular Electrostimulation on Sympathetic Nerve Activity in Patients With Type 2 Diabetes (ELECTROSYMP2) (ELECTROSYMP2)
August 23, 2022 updated by: University Hospital, Caen
Physical activity (PA) is recommended for the treatment of subjects with type 2 diabetes to increase insulin sensitivity and improve metabolic control.
However, adherence to PA is often poor, due to a lack of motivation or due to disabling complications or comorbidities.
Neuromuscular electrostimulation (NMES) is a physical treatment commonly used to improve muscle strength and volume in several situations: after stroke, after limb trauma or during chest rehabilitation in deconditioned patients.
The investigators have already shown in a first pilot study (manuscript in preparation) that NMES improves insulin sensitivity : in the study ELECTRODIAB (No. ID-RCB: 2011-A00930-41), the investigators showed a 25% insulin sensitivity improvement after a week of daily 25-min bi-quadricipital NMES session, in a population of patients with orally-treated type 2 diabetes.
Insulin sensitivity increased up to 50% in the most deconditioned subjects.
Discrepancy between this result and the very low energy expenditure measured during sessions suggests that the metabolic effect was not solely mediated by muscle contractions.
The investigators hypothesize the involvement of neurological pathways.
Indeed, it is demonstrated that the autonomic nervous system is an important regulator of glucose metabolism with pancreatic action, a key role in energy metabolism and a complex relationship with insulin resistance.
Muscle activity, whether static (isometric) or dynamic causes changes in sympathetic nerve activity in healthy subjects but its effect in type 2 diabetic subjects is not known.
The investigators hypothesize that, in type 2 diabetic subjects, the modulation of sympathetic nerve activity by NMES could be involved in the improvement of insulin sensitivity.
To address this question, the investigators propose to assess sympathetic nerve activity with the gold standard method of microneurography before and after a single bi-quadricipital NMES session.
The impact of neuro-electro-stimulation (NES) (a sensitive stimulation under muscular threshold) and the impact of voluntary isometric muscle contractions (VC) will also be evaluated.
These procedures will also be applied in healthy control subjects.
Study Overview
Status
Withdrawn
Conditions
Study Type
Interventional
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Caen, France, 14033
- Clinical Research Center Caen University Hospital
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
14 years to 66 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- type 2 diabetes for at least 12 month
- treatment by oral hypoglycemic agents and/or GLP1 agonists
- HbA1c : 6-10%
- suspected insulin-resistance (at least one criteria below) :
- waist circumference > 80cm (female); > 94cm (male)
- triglycerides > 150 mg/dl
- HDL-cholesterol < 50 mg/dl (female); < 40 mg/dl (male)
- low background physical activity (Ricci-Gagnon score < 27)
Exclusion Criteria:
- type 1 diabetes
- treatment with insulin
- seizure
- pace maker
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: effect of neuromuscular electrostimulation (NMES)
|
Each subject (type 2 diabetes and control) will be assessed with plethysmography during a single session of neuromuscular electrostimulation (NMES).
|
|
Experimental: effect of neuro electrostimulation (NES)
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Each subject (type 2 diabetes and control) will be assessed with plethysmography during a single session of neuro electrostimulation (NES)
|
|
Experimental: effect of voluntary contractions (VC)
|
Each subject (type 2 diabetes and control) will be assessed with plethysmography during a single session of voluntary contractions (VC)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Sympathetic nerve reactivity in response to a single session of neuromuscular electrostimulation
Time Frame: at 0, 5, 10, 15, 20 min of the NMES session
|
Sympathetic nerve reactivity will be assessed by plethysmography, with a Valsalva procedure, at baseline and every 5 minutes during a 20-min session of biquadricipital neuromuscular electrostimulation
|
at 0, 5, 10, 15, 20 min of the NMES session
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
sympathetic nerve reactivity in response to a single session of neuro electrostimulation
Time Frame: at 0, 5, 10, 15, 20 min of the NES session
|
Sympathetic nerve reactivity will be assessed by plethysmography, with a Valsalva procedure, at baseline and every 5 minutes during a 20-min session of biquadricipital neuro electrostimulation
|
at 0, 5, 10, 15, 20 min of the NES session
|
|
sympathetic nerve reactivity in response to a single session of voluntary muscular contractions
Time Frame: at 0, 5, 10, 15, 20 min of the VC session
|
Sympathetic nerve reactivity will be assessed by plethysmography, with a Valsalva procedure, at baseline and every 5 minutes during a 20-min session of biquadricipital voluntary contractions
|
at 0, 5, 10, 15, 20 min of the VC session
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
comparison of sympathetic nerve reactivity between the different groups and procedures
Time Frame: at 0, 5, 10, 15, 20 min of each session
|
sympathetic nerve reactivity will be compared between type 2 diabetic and healthy subjects and between neuromuscular electrostimulation, neuro electrostimulation and voluntary contractions
|
at 0, 5, 10, 15, 20 min of each session
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Michael JOUBERT, MD, University Hospital, Caen
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 1, 2020
Primary Completion (Anticipated)
December 1, 2021
Study Completion (Anticipated)
June 1, 2022
Study Registration Dates
First Submitted
June 18, 2014
First Submitted That Met QC Criteria
June 20, 2014
First Posted (Estimate)
June 24, 2014
Study Record Updates
Last Update Posted (Actual)
August 24, 2022
Last Update Submitted That Met QC Criteria
August 23, 2022
Last Verified
August 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2014-A00559-38
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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