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CC BY 4.0 · Exp Clin Endocrinol Diabetes 2024; 132(11): 622-630
DOI: 10.1055/a-2406-4491
Article

A Single Sauna Session Does Not Improve Postprandial Blood Glucose Handling in Individuals with Type 2 Diabetes Mellitus: A Cross-Over, Randomized, Controlled Trial

Laura Schenaarts
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
,
Floris K Hendriks
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
,
Cas J Fuchs
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
,
Wendy EM Sluijsmans
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
,
Tim Snijders
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
,
Luc JC van Loon
1   Department of Human Biology, Maastricht University School of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Ringgold ID: RIN385783)
› Institutsangaben Clinical Trial:Registration number (trial ID): NCT05610046, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Randomized, controlled trial
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Abstract

Introduction Passive heat treatment has been suggested to improve glycemic control in individuals with type 2 diabetes mellitus (T2DM). Previous studies have focused predominantly on hot water immersion and traditional sauna bathing, as opposed to the more novel method of infrared-based sauna bathing. Here, the impact of a single infrared sauna session on post-prandial glycemic control was assessed in older individuals with T2DM.

Methods In this randomized controlled crossover trial, 12 participants with T2DM (male/female: 10/2, age: 69±7 y, BMI: 27.5±2.9 kg/m2) rested in an infrared sauna twice: once in a heated (60°C) and once in a thermoneutral (21°C) condition for 40 min, immediately followed by a 2-h oral glucose tolerance test (OGTT). Venous blood samples were obtained to assess plasma glucose and insulin concentrations and to determine the whole-body composite insulin sensitivity index.

Results Body core and leg skin temperature were higher following the heated condition compared to the thermoneutral condition (38.0±0.3 vs. 36.6±0.2°C and 39.4±0.8 vs. 31.3±0.8°C, respectively; P<0.001 for both). The incremental area under the curve (iAUC) of plasma glucose concentrations during the OGTT was higher after the heated condition compared to the thermoneutral condition (17.7±3.1 vs. 14.8±2.8 mmol/L/120 min; P<0.001). No differences were observed in plasma insulin concentrations (heated: 380±194 vs. thermoneutral: 376±210 pmol/L/120 min; P=0.93) or whole-body composite insulin sensitivity indexes (4.5±2.8 vs. 4.5±2.1; P=0.67).

Conclusions A single infrared sauna session does not improve postprandial blood glucose handling in individuals with T2DM. Future studies should assess the effect of more prolonged application of infrared sauna bathing on daily glycemic control.

Keywords

passive heating - glucose tolerance test - insulin sensitivity - glucose metabolism - thermoregulation

Supplementary Material



Publikationsverlauf

Eingereicht: 08. Februar 2024

Angenommen nach Revision: 28. August 2024

Accepted Manuscript online:
29. August 2024

Artikel online veröffentlicht:
26. September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Laakso M. Hyperglycemia and cardiovascular disease in type 2 diabetes. Diabetes 1999; 48: 937-942
    CrossrefPubMedGoogle Scholar
  • 2 Polonsky WH, Henry RR. Poor medication adherence in type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Prefer Adherence 2016; 10: 1299-1307
    CrossrefPubMedGoogle Scholar
  • 3 Colberg SR, Sigal RJ, Fernhall B. et al. Exercise and type 2 diabetes: The American College of Sports Medicine and the American Diabetes Association: Joint position statement. Diabetes Care 2010; 33: e147-e167
    CrossrefPubMedGoogle Scholar
  • 4 Stutts WC. Physical activity determinants in adults. Perceived benefits, barriers, and self efficacy. Aaohn J 2002; 50: 499-507
    CrossrefPubMedGoogle Scholar
  • 5 Praet SFE, van Rooij ESJ, Wijtvliet A. et al. Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: A randomised controlled trial. Diabetologia 2008; 51: 736-746
    CrossrefPubMedGoogle Scholar
  • 6 Cullen T, Clarke ND, Hill M. et al. The health benefits of passive heating and aerobic exercise: To what extent do the mechanisms overlap?. J Appl Physiol 2020; 129: 1304-1309
    CrossrefPubMedGoogle Scholar
  • 7 Munan M, Oliveira CLP, Marcotte-Chénard A. et al. Acute and Chronic effects of exercise on continuous glucose monitoring outcomes in type 2 diabetes: A meta-analysis. Front Endocrinol (Lausanne) 2020; 11: 495
    CrossrefPubMedGoogle Scholar
  • 8 Rowell LB. Human cardiovascular adjustments to exercise and thermal stress. Physiol Rev 1974; 54: 75-159
    CrossrefPubMedGoogle Scholar
  • 9 Pearson J, Low DA, Stöhr E. et al. Hemodynamic responses to heat stress in the resting and exercising human leg: Insight into the effect of temperature on skeletal muscle blood flow. Am J Physiol Regul Integr Comp Physiol 2011; 300: R663-R673
    CrossrefPubMedGoogle Scholar
  • 10 Rowell LB, Brengelmann GL, Blackmon JR. et al. Redistribution of blood flow during sustained high skin temperature in resting man. J Appl Physiol 1970; 28: 415-420
    CrossrefPubMedGoogle Scholar
  • 11 Detry JM, Brengelmann GL, Rowell LB. et al. Skin and muscle components of forearm blood flow in directly heated resting man. J Appl Physiol 1972; 32: 506-511
    CrossrefPubMedGoogle Scholar
  • 12 Heinonen I, Brothers RM, Kemppainen J. et al. Local heating, but not indirect whole body heating, increases human skeletal muscle blood flow. J Appl Physiol 2011; 111: 818-824
    CrossrefPubMedGoogle Scholar
  • 13 Keller DM, Sander M, Stallknecht B. et al. α-Adrenergic vasoconstrictor responsiveness is preserved in the heated human leg. J Physiol 2010; 588: 3799-3808
    CrossrefPubMedGoogle Scholar
  • 14 Baron AD, Steinberg H, Brechtel G. et al. Skeletal muscle blood flow independently modulates insulin-mediated glucose uptake. Am J Physiol 1994; 266: E248-E253
    PubMedGoogle Scholar
  • 15 Behzadi P, Ravanelli N, Gravel H. et al. Acute effect of passive heat exposure on markers of cardiometabolic function in adults with type 2 diabetes mellitus. J Appl Physiol 2022; 132: 1154-1166
    CrossrefPubMedGoogle Scholar
  • 16 Rivas E, Newmire DE, Crandall CG. et al. An acute bout of whole body passive hyperthermia increases plasma leptin, but does not alter glucose or insulin responses in obese type 2 diabetics and healthy adults. J Therm Biol 2016; 59: 26-33
    CrossrefPubMedGoogle Scholar
  • 17 James TJ, Corbett J, Cummings M. et al. Timing of acute passive heating on glucose tolerance and blood pressure in people with type 2 diabetes: A randomized, balanced crossover, control trial. J Appl Physiol 2021; 130: 1093-1105
    CrossrefPubMedGoogle Scholar
  • 18 Su Y, Hoekstra SP, Leicht CA. Hot water immersion is associated with higher thermal comfort than dry passive heating for a similar rise in rectal temperature and plasma interleukin-6 concentration. Eur J Appl Physiol 2024; 124: 1109-1119
    CrossrefPubMedGoogle Scholar
  • 19 Campbell HA, Akerman AP, Kissling LS. et al. Acute physiological and psychophysical responses to different modes of heat stress. Exp Physiol 2022; 107: 429-440
    CrossrefPubMedGoogle Scholar
  • 20 Laukkanen JA, Kunutsor SK. The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna. Temperature 2024; 11: 27-51
    CrossrefPubMedGoogle Scholar
  • 21 Tsai SR, Hamblin MR. Biological effects and medical applications of infrared radiation. J Photochem Photobiol B 2017; 170: 197-207
    CrossrefPubMedGoogle Scholar
  • 22 National Institute of Public Health and the Environment MoH W, and Sport, The Netherlands Dutch Food Composition Database 2021. 2021 https://www.rivm.nl/en/dutch-food-composition-database
    PubMed
  • 23 Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: Comparison with the euglycemic insulin clamp. Diabetes Care 1999; 22: 1462-1470
    CrossrefPubMedGoogle Scholar
  • 24 Abdul-Ghani MA, Matsuda M, Balas B. et al. Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test. Diabetes Care 2007; 30: 89-94
    CrossrefPubMedGoogle Scholar
  • 25 Matthews DR, Hosker JP, Rudenski AS. et al. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419
    CrossrefPubMedGoogle Scholar
  • 26 Hoekstra SP, Bishop NC, Faulkner SH. et al. Acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults. J Appl Physiol 2018; 125: 2008-2018
    CrossrefPubMedGoogle Scholar
  • 27 Faulkner SH, Jackson S, Fatania G. et al. The effect of passive heating on heat shock protein 70 and interleukin-6: A possible treatment tool for metabolic diseases?. Temperature 2017; 4: 292-304
    CrossrefPubMedGoogle Scholar
  • 28 Maley MJ, Hunt AP, Stewart IB. et al. Hot water immersion acutely reduces peripheral glucose uptake in young healthy males: An exploratory crossover randomized controlled trial. Temperature. 2023 10. 434-443
    PubMedGoogle Scholar
  • 29 Hoekstra SP, Ogawa T, Dos Santos M. et al. The effects of local versus systemic passive heating on the acute inflammatory, vascular and glycaemic response. Appl Physiol Nutr Metab 2021; 46: 808-818
    CrossrefPubMedGoogle Scholar
  • 30 Leicht CA, James LJ, Briscoe JHB. et al. Hot water immersion acutely increases postprandial glucose concentrations. Physiol Rep 2019; 7: e14223
    CrossrefPubMedGoogle Scholar
  • 31 Iguchi M, Littmann AE, Chang SH. et al. Heat stress and cardiovascular, hormonal, and heat shock proteins in humans. J Athl Train 2012; 47: 184-190
    CrossrefPubMedGoogle Scholar
  • 32 Faure C, Charlot K, Henri S. et al. Impaired glucose tolerance after brief heat exposure: A randomized crossover study in healthy young men. Clin Sci 2016; 130: 1017-1025
    CrossrefPubMedGoogle Scholar
  • 33 Dumke CL, Slivka DR, Cuddy JS. et al. The effect of environmental temperature on glucose and insulin after an oral glucose tolerance test in healthy young men. Wilderness Environ Med 2015; 26: 335-342
    CrossrefPubMedGoogle Scholar
  • 34 Carroll HA, Templeman I, Chen YC. et al. Effect of acute hypohydration on glycemic regulation in healthy adults: A randomized crossover trial. J Appl Physiol 2019; 126: 422-430
    CrossrefPubMedGoogle Scholar
  • 35 Akanji AO, Oputa RN. The effect of ambient temperature on glucose tolerance. Diabet Med 1991; 8: 946-948
    CrossrefPubMedGoogle Scholar
  • 36 Frayn KN, Whyte PL, Benson HA. et al. Changes in forearm blood flow at elevated ambient temperature and their role in the apparent impairment of glucose tolerance. Clin Sci 1989; 76: 323-328
    CrossrefPubMedGoogle Scholar
  • 37 Zello GA, Smith JM, Pencharz PB. et al. Development of a heating device for sampling arterialized venous blood from a hand vein. Ann Clin Biochem 1990; 27: 366-372
    CrossrefPubMedGoogle Scholar
  • 38 Hargreaves M, Angus D, Howlett K. et al. Effect of heat stress on glucose kinetics during exercise. J Appl Physiol 1996; 81: 1594-1597
    CrossrefPubMedGoogle Scholar
  • 39 Tatár P, Vigas M, Jurcovicová J. et al. Impaired glucose utilization in man during acute exposure to environmental heat. Endocrinol Exp 1985; 19: 277-281
    PubMedGoogle Scholar
  • 40 Rowell LB, Detry JR, Profant GR. et al. Splanchnic vasoconstriction in hyperthermic man--role of falling blood pressure. J Appl Physiol 1971; 31: 864-869
    CrossrefPubMedGoogle Scholar
  • 41 Meier JJ, Baller B, Menge BA. et al. Excess glycaemic excursions after an oral glucose tolerance test compared with a mixed meal challenge and self-measured home glucose profiles: Is the OGTT a valid predictor of postprandial hyperglycaemia and vice versa?. Diabetes Obes Metab 2009; 11: 213-222
    CrossrefPubMedGoogle Scholar
  • 42 Hesketh K, Shepherd SO, Strauss JA. et al. Passive heat therapy in sedentary humans increases skeletal muscle capillarization and eNOS content but not mitochondrial density or GLUT4 content. Am J Physiol Heart Circ Physiol 2019; 317: H114-H123
    CrossrefPubMedGoogle Scholar
  • 43 Pallubinsky H, Phielix E, Dautzenberg B. et al. Passive exposure to heat improves glucose metabolism in overweight humans. Acta Physiol (Oxf) 2020; 229: e13488
    CrossrefPubMedGoogle Scholar
  • 44 Hooper PL. Hot-tub therapy for type 2 diabetes mellitus. N Engl J Med 1999; 341: 924-925
    CrossrefPubMedGoogle Scholar