Efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus: A randomized SHAM-controlled trial

Abstract

Aims: To determine the efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus (T2D), and any persistent benefits 7 weeks following treatment.

Methods: 50 participants with T2D were randomly assigned to either 1) 20x45-minute ECP sessions over 7 weeks (ECP₄₅), 2) 20x30-minute ECP sessions over 7 weeks (ECP₃₀) or 3) SHAM control. Outcomes were assessed at baseline, after 7 weeks of the intervention and 7 weeks after the interventions finished. Efficacy was determined from changes in HbA_1c.

Results: After 7 weeks, there were significant between-group differences, with ECP₄₅ lowering HbA_1c compared to SHAM (mean [95% CI] -0.7 [-0.1 to -1.3] %; -7 [-1 to -15] mmol/mol). Within group changes were; ECP₄₅ (mean ± SD -0.8 ± 0.8%; -8 ± 8 mmol/mol), ECP₃₀ (-0.2 ± 0.5%; -2 ± 6 mmol/mol) and SHAM (-0.1 ± 0.9%; -1 ± 10 mmol/mol). HbA_1c in the ECP₄₅ group remained lower 7 weeks after completing the intervention; ECP₄₅ (7.0 ± 1.1%; 53 ± 26 mmol/mol), ECP₃₀ (7.7 ± 1.4%; 60 ± 16 mmol/mol) and SHAM (7.7 ± 1.0%; 60 ± 10 mmol/mol).

Conclusions: In people with T2D, ECP₄₅ for 7 weeks improved glycemic control when compared to ECP₃₀ and a SHAM control group.

Keywords: Basal disposition index; Beta cell function; HbA(1c); Insulin resistance Insulin resistance; Insulin sensitivity.