Beneficial effect of whole body vibration on glycemic control and comprehensive treatment of type 2 diabetes

Although type 2 diabetes mellitus (T2DM) is characterized by impaired carbohydrate metabolism with impaired glucose lowering, patients, especially the elderly, are at a risk of the treatment-induced hypoglycaemia. They often suffer also from falls and depressive symptoms. Research shows that exercise training has an extremely positive effect on functional performance, glycemic control and mental well-being in elderly patients, providing comprehensive diabetes management. However, the elderly lack adequate mobilization to perform regular active exercises. It is speculated that vibrotherapy can help here, as a passive training modality that activates the neuromuscular system and increases metabolism. Therefore, Japanese scientists decided to investigate the effect of a specific type of vibrotherapy, whole-body vibration (WBV), on the T2DM elderly patients condition.

• After WBV an improvement in the functional ability was achieved, as was shown by TUG test results [the test time in the control group (no vibration) did not change significantly, while in the WBV group it decreased from 7.0 ± 1.0 to 6.6 ± 0.9 s].
• Only the WBV group showed a significant improvement in glycemia, based on the permanently glycated haemoglobin HbA1C levels, which decreased from 7.2 ± 0.8 before the treatment to 6.9 ± 0.5 after WBV.
• WBV improved the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Geriatric Depression Scale (GDS) scores, while no statistically significant changes were found in the control group.
• There were no hypoglycemic events during the study.
• The feasibility of the WBV program by patients was 93.3 ± 8.0 %.

Prepared on the basis of:

Favorable Effects of 24-Week Whole-Body Vibration on Glycemic Control and Comprehensive Diabetes Therapy in Elderly Patients with Type 2 Diabetes. Kitamoto T, Saegusa R, Tashiro T, Sakurai T et al. Diabetes Ther. 2021 Jun;12(6):1751-1761.

Study population

26 elderly patients (over 65 years of age) with T2DM (WBV group: n = 14; vibration-free control group: n = 12) were analyzed.

Test procedure

The WBV program ran for 6 months. WBV was not administered to the control group, and no other interventions were used there, apart from appropriate exercise counseling {presumably to implement it after the experimental program; editorial note}, which was also conducted in the WBV group. The primary research objective was functional fitness assessment using the Timed Up and Go (TUG) test, sit-to-stand (SST) test, gait length measurement, and grip test. Secondary goals were global glycemic control and survey assessment of the DTSQ and the GDS. Selected features were analyzed before vs. after the intervention.

Use of vibration in the study

The Power-Plate pro6+ vibration platform (TM, USA) was used, on which patients performed one 15-minute session three times a week for 24 weeks (72 sessions in total) with at least 1 day rest between sessions. There were 11 body positions used on the platform, selected in such a way that the maximum vibration impact was successively delivered into the selected target muscle. Between positions, which were held for 30-60 seconds, participants had 30 seconds to recover. Vibration frequencies of 30-39 Hz and amplitudes of 2-4 mm were used.

Results

Only in the WBV group an improvement was observed in the TUG and SST [TUG: 7.1 ± 0.9 or 7.1 ± 0.8 vs 7.0 ± 1.0 or 6.6 ± 0.9 [s], P = 0.63 or 0.01 – control vs WBV, respectively; SST: 10.4 ± 1.9 or 11.3 ± 2.4 vs 9.7 ± 2.3 or 9.5 ± 2.1 [s], P = 0.62 or P < 0.01 – control vs WBV, respectively]. The WBV group showed a significant improvement in the levels of permanently glycated haemoglobin HbA1C (7.2 ± 0.8 vs 6.9 ± 0.5, P < 0.01) and DTSQ and GDS, while in the control group there were no statistically significant changes in these parameters. There were no hypoglycemic events during the study. The feasibility of the WBV program by patients was 93.3 ± 8.0 %.

Comment

The authors of the presented article conclude that the use of vibrotherapy in the form of a 6-month WBV exercise program during hospitalization was well-tolerated, safe, and potentially effective in glycemic control. In addition, it improved balance by preventing falls, as well as positively influenced the mood of older T2DM patients. Therefore, it is suggested to conduct further clinical trials on the influence of WBV on the treatment of diabetes mellitus.

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