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

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 HbA1c.

Results
After 7 weeks, there were significant between-group differences, with ECP45 lowering HbA1c 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). HbA1c 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.