Improving Glycemic Control with Electrical Stimulation in Mexican-Americans

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PROJECT ABSTRACT/SUMMARY Over the few decades, metabolic diseases such as obesity, insulin resistance, and type 2 diabetes have risen to epidemic proportions, particularly among Mexican-Americans, and are leading to a high health care costs nationwide. Meanwhile, adherence to physical activity to prevent these metabolic diseases has declined. A majority (80%) of adults in the US do not meet the ACSM-recommended 150 minutes of moderate or 75 minutes of vigorous exercise per week. Mexican-Americans have greater prevalence of physical inactivity compared to the general population. Therefore, it is critical to develop additional strategies to increase adoption and adherence to physical activity in this at-risk population. The long-term goal of our research is to explore effective strategies to improve glycemic control, insulin sensitivity and metabolic health in sedentary humans, particularly those who are unable to exercise or are at risk for developing T2D. Neuromuscular Electrical Stimulation (e-stim) is a practical, non-invasive, cost-effective and innovative method to promote an alternative mode of muscle contraction among individuals who are less likely to engage in conventional physical activity. Over the past decade, we have developed and established in vitro exercise models using e- stim to contract human primary muscle cells (myotubes) to study the mechanisms by which muscle contraction positively influences insulin sensitivity and lipid metabolism. Although e-stim is widely used in rehabilitation settings to prevent muscle loss, there is a gap in the literature defining the effectiveness of e-stim to improve insulin sensitivity and metabolic health. Our preliminary data and existing literature indicate a promising application of e-stim to improve glycemic control, insulin sensitivity and metabolic health in an at-risk sedentary, overweight or obese population. Based on our preliminary data, we propose to perform a comprehensive randomized controlled trial (n=30) to determine the effects of 8 weeks of e-stim, on glycemic control as measured by continuous glucose monitoring, insulin sensitivity by oral glucose tolerance test, energy metabolism (resting metabolic rate, substrate utilization, blood lipid and metabolic profile), body composition, and muscle strength in an at-risk, sedentary, overweight/obese, Mexican-American population. We hypothesize that e-stim will improve 24 hour. glycemic control, increase insulin sensitivity, and improve overall metabolic health in this population. This study will allow us to evaluate the feasibility of using e-stim as a novel preventative treatment for insulin resistance and metabolic diseases in a sedentary population and will lay the foundation for a larger clinical trial with potential to impact clinical practice to prevent and treat type 2 diabetes.