A new research article was published in the Journal of Applied Physiology talking about a new way to improve glucose metabolism for patients suffering from type-II diabetes. The aim of this research was to determine what mechanism brought about the results from a 1999 study where taking patients participated in a hot water treatment. This meant they would be submerged for 30 minutes within a tub of hot water up to their shoulders. Over a three-week period, the patients showed a decrease in weight, fasting blood glucose levels decreased, and their average glycosylated blood levels also decreased (1). The most recent article continued this research by hypothesizing that the effect on glucose levels is a response to the hot water treatment and how it affects inflammation levels and increased glucose uptake. The authors admit that this should only be done as a supplemental treatment but show a possible avenue into further research on how inflammation effects diabetes patients. This is an important finding because not all patients diagnosed with Type-II diabetes are able to exercise providing a supplemental option for these patients.
The research talks about how the patients experienced the same acute response as triggered by exercise. The acute response to the hot water treatment showed an increase in the amount of circulatory nitric oxide levels (2). Research has shown that nitric oxide stimulates glucose uptake through its own distinct pathway called the Phosphatidylinositol-3-Kinase Independent Pathway. This pathway is caused by the release of nitric oxide from exercise-stimulated skeletal muscles causing an acute response by an increase in glucose transport to skeletal muscles, leading to increasing levels of glycolysis (3). Researchers also found that after two weeks of hot water treatment, patients saw decreased levels of fasting blood glucose levels as well as decrease levels in inflammation (2). By increasing the amount of glucose transport to the skeletal muscles’ through nitric oxide, patients who are insulin resistant are able to remove the glucose from their blood.
Even though this article talks about a way in which people suffering from type-II diabetes are able lower blood glucose levels without the use of insulin, they make sure to say that this should only be used in supplement to their prescribed treatment. This is due to the glucose uptake only being stimulated by exercise or the hot water treatment. Another issue with this research is that some patients experienced discomfort and loss of balance due to the heat of the water they were placed in. The authors expressed that further research should be done to see if a shorter length of time may bring about similar results, decreasing the discomfort that these patients felt.
Article Link: https://www.medicalnewstoday.com/articles/323702.php
Citations:
1: Hot-Tub Therapy for Type 2 Diabetes Mellitus | NEJM. (n.d.). Retrieved November 21, 2018, from http://www.nejm.org/doi/10.1056/NEJM199909163411216?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dwww.ncbi.nlm.nih.gov
2: Hoekstra, S. P., Bishop, N. C., Faulkner, S. H., Bailey, S. J., & Leicht, C. A. (2018). The acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00407.2018
3: Etgen, G. J., Fryburg, D. A., & Gibbs, E. M. (1997). Nitric Oxide Stimulates Skeletal Muscle Glucose Transport Through a Calcium/Contraction– and Phosphatidylinositol-3-Kinase–Independent Pathway. Diabetes, 46(11), 1915–1919. https://doi.org/10.2337/diab.46.11.1915
This reminds me of a blog I wrote recently about brown fat thermogenesis and its effects on weight loss and satiation. Although a different pathway, it is interesting that heat, in various forms, can have so many physiological responses. I wonder how this mechanism of being submerged in hot water leads to activation of specific pathways and how thermoreceptors are responsible. Any sort of insight such as this is important in the understanding of metabolic pathways and disease.
ReplyDeleteWhile this study seems promising for supplemental treatment, I believe that there needs to be much more research on the idea that heat can decrease insulin dosage in diabetic patients. This study only had 8 subjects, 3 of which were actually taking insulin. The other 5 subjects were on other hypoglycemic oral medications.
ReplyDeleteI did find some answers to why the hot tub therapy could potentially be causing an improvement in these Type 2 diabetics. Heat shock proteins were discovered about 50 years ago and seem to have a protective effect on metabolic processes. Several studies are looking at the activation of heat shock proteins (active during times of cellular stress) and how they increase insulin sensitivity and inflammation against insulin resistance.
So, it turns out that this hot tub therapy is onto something, but may need a better sample size and further research to support their results.
https://www-ncbi-nlm-nih-gov.dml.regis.edu/pmc/articles/PMC4216407/
DeleteA very interesting study and one that should definitely be further investigated as obesity and type 2 diabetes rates continue to rise throughout the world. I think a great addition to this study would be looking into the psychological effects of taking 30 minutes to yourself and relaxing. While I personally do not take a bath every night, I greatly enjoy relaxing in a hot tub. It seems every time I sit in a hot tub I come out completely relaxed and most often, ready to sleep. While it may be hard to measure the psychological affects and what impact it might have on diabetes, I am sure there is a way and may show even more promising results.
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