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Chidambaram Y, Vijayakumar V, Ravi P, Boopalan D, Anandhan A, Kuppusamy M. Does hydrotherapy influence plasma glucose levels in type 2 diabetes? - A scoping review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 21:14-18. [PMID: 37183593 DOI: 10.1515/jcim-2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Hydrotherapy is a commonly used treatment modality to manage various conditions including diabetes in the Naturopathy system of medicine. The objective of the current scoping review is to find the effectiveness of hydrotherapy on plasma blood glucose levels in type 2 diabetes. CONTENT Arksey and O'Malley's five-stage framework was adopted for this scoping review. The studies which used hydrotherapy intervention for the management of diabetes or the effect of hydrotherapy on plasma glucose levels were considered eligible. PubMed/MEDLINE, EMBASE, Cochrane library, and Google scholar were searched for English- language published articles till December 20, 2022. The following Medical Subject Headings (MeSH) and keyword search terms were used ("diabetes" OR "type 2 diabetes" OR "diabetes mellitus" OR "plasma glucose level") AND ("hydrotherapy" OR "water therapy" OR "balneotherapy"). Two investigators independently assessed the studies for inclusion. Review articles, abstracts, and articles including the aquatic exercises as interventions were excluded. SUMMARY In total, six studies met the inclusion criteria. Out of six, two studies used hot therapies, two studies cold therapy, and the remaining two used both hot and cold as interventions. The study results showed that hydrotherapy can be used as an effective intervention tool for blood glucose levels in patients with type 2 diabetes. OUTLOOK Integrating hydrotherapy treatments alongside conventional management can reduce blood glucose levels and thus reduce diabetes-related complications.
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Affiliation(s)
- Yogapriya Chidambaram
- Department of Naturopathy, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Venugopal Vijayakumar
- Department of Yoga, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Poornima Ravi
- Department of Yoga and Naturopathy, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Deenadayalan Boopalan
- Department of Naturopathy, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Akila Anandhan
- Department of Acupuncture and Energy Medicine, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Maheshkumar Kuppusamy
- Department of Physiology, Govt. Yoga and Naturopathy Medical College and Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
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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 (Austin) 2024; 11:27-51. [PMID: 38577299 PMCID: PMC10989710 DOI: 10.1080/23328940.2023.2300623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 04/06/2024] Open
Abstract
Passive heat therapy is characterized by exposure to a high environmental temperature for a brief period. There are several types of passive heat therapy which include hot tubs, Waon therapy, hydrotherapy, sanarium, steam baths, infrared saunas and Finnish saunas. The most commonly used and widely studied till date are the Finnish saunas, which are characterized by high temperatures (ranging from 80-100°C) and dry air with relative humidity varying from 10-20%. The goal of this review is to provide a summary of the current evidence on the impact of passive heat therapies particularly Finnish saunas on various health outcomes, while acknowledging the potential of these therapies to contribute to the extension of healthspan, based on their demonstrated health benefits and disease prevention capabilities. The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity. Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity. The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function. Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations.
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Affiliation(s)
- Jari A. Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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James TJ, Corbett J, Cummings M, Allard S, Shute JK, Belcher H, Mayes H, Gould AAM, Piccolo DD, Tipton M, Perissiou M, Saynor ZL, Shepherd AI. The effect of repeated hot water immersion on insulin sensitivity, heat shock protein 70, and inflammation in individuals with type 2 diabetes mellitus. Am J Physiol Endocrinol Metab 2023; 325:E755-E763. [PMID: 37938179 DOI: 10.1152/ajpendo.00222.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/09/2023]
Abstract
Repeated hot water immersion (HWI) can improve glycemic control in healthy individuals but data are limited for individuals with type 2 diabetes mellitus (T2DM). The present study investigated whether repeated HWI improves insulin sensitivity and inflammatory status and reduces plasma ([extracellular heat shock protein 70]) [eHSP70] and resting metabolic rate (RMR). Fourteen individuals with T2DM participated in this pre- versus postintervention study, with outcome measures assessed in fasted (≥12 h) and postprandial (2-h post-75 g glucose ingestion) states. HWI consisted of 1 h in 40°C water (target rectal temperature 38.5°C-39°C) repeated 8-10 times within a 14-day period. Outcome measures included insulin sensitivity, plasma [glucose], [insulin], [eHSP70], inflammatory markers, RMR, and substrate utilization. The HWI intervention increased fasted insulin sensitivity (QUICKI; P = 0.03) and lowered fasted plasma [insulin] (P = 0.04), but fasting plasma [glucose] (P = 0.83), [eHSP70] (P = 0.08), [IL-6] (P = 0.55), [IL-10] (P = 0.59), postprandial insulin sensitivity (P = 0.19), plasma [glucose] (P = 0.40), and [insulin] (P = 0.47) were not different. RMR was reduced by 6.63% (P < 0.05), although carbohydrate (P = 0.43) and fat oxidation (P = 0.99) rates were unchanged. This study shows that 8-10 HWIs within a 14-day period improved fasting insulin sensitivity and plasma [insulin] in individuals with T2DM, but not when glucose tolerance is challenged. HWI also improves metabolic efficiency (i.e., reduced RMR). Together these results could be clinically important and have implications for metabolic health outcomes and well-being in individuals with T2DM.NEW & NOTEWORTHY This is the first study to investigate repeated HWI to raise deep body temperature on insulin sensitivity, inflammation, eHSP70, and substrate utilization in individuals with T2DM. The principal novel findings were improvements in fasting insulin sensitivity and fasting plasma [insulin] but no change in fasting plasma [glucose], postprandial insulin sensitivity, plasma [insulin], or [glucose]. There was also no change in eHSP70, inflammatory status, or substrate utilization but there were reductions in RMR and oxygen consumption.
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Affiliation(s)
- Thomas J James
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Jo Corbett
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Michael Cummings
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Sharon Allard
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Janis K Shute
- Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Harvey Belcher
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Harry Mayes
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Alex A M Gould
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Daniel D Piccolo
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Michael Tipton
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Maria Perissiou
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Zoe L Saynor
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Anthony I Shepherd
- Faculty of Science and Health, Physical Activity, Health and Rehabilitation Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
- Faculty of Science and Health, Extreme Environments Theme, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
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AlSabagh AT, Rao MS, Renno WM. The impact of heat therapy on neuromuscular function and muscle atrophy in diabetic rats. Front Physiol 2023; 13:1039588. [PMID: 36685197 PMCID: PMC9849254 DOI: 10.3389/fphys.2022.1039588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction: Diabetes Mellitus (DM) is the most common metabolic disease worldwide and is associated with many systemic complications. Muscle atrophy is one of the significant complications in DM patients, making routine tasks laborious as atrophy continues. It is known that heat stress stimulates heat shock proteins and other proteins that maintain muscle mass; however, it is not thoroughly studied in diabetic conditions. This study addressed whether heat therapy can attenuate muscle atrophy in STZ-induced diabetic rats and explored its mechanism of action on specific muscle proteins. Methods: Male Sprague Dawley rats were randomly divided into short-term (3 weeks) and long-term (6 weeks) experiments. In each experiment rats were divided into control, heat therapy, diabetic and diabetic + heat therapy groups. Rats in heat therapy groups were exposed to heat therapy for 30 min daily for three or six weeks in a temperature-controlled (42°C) chamber. Results: The attenuation of neuromuscular functions assessed by Rotarod, Kondziella's inverted screen, and extensor postural thrust tests showed that diabetic rats exposed to heat therapy performed significantly better than diabetic controls. Muscle cross sectional area data established that heat therapy reduced muscle atrophy by 34.3% within 3 weeks and 44.1% within 6 weeks in the diabetic groups. Further, heat therapy significantly decreased muscle atrophy markers (CD68, KLF, and MAFbx) and significantly elevated muscle hypertrophy markers (AKT, mTOR, and HSP70). Conclusions: This study shows the relevance and clinical significance of utilizing heat therapy as a viable treatment to attenuate muscle atrophy in diabetic patients.
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Localized Heat Therapy Improves Mitochondrial Respiratory Capacity but Not Fatty Acid Oxidation. Int J Mol Sci 2022; 23:ijms23158500. [PMID: 35955635 PMCID: PMC9369322 DOI: 10.3390/ijms23158500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/26/2022] Open
Abstract
AIM: Mild heat stress can improve mitochondrial respiratory capacity in skeletal muscle. However, long-term heat interventions are scarce, and the effects of heat therapy need to be understood in the context of the adaptations which follow the more complex combination of stimuli from exercise training. The purpose of this work was to compare the effects of 6 weeks of localized heat therapy on human skeletal muscle mitochondria to single-leg interval training. METHODS: Thirty-five subjects were assigned to receive sham therapy, short-wave diathermy heat therapy, or single-leg interval exercise training, localized to the quadriceps muscles of the right leg. All interventions took place 3 times per week. Muscle biopsies were performed at baseline, and after 3 and 6 weeks of intervention. Mitochondrial respiratory capacity was assessed on permeabilized muscle fibers via high-resolution respirometry. RESULTS: The primary finding of this work was that heat therapy and exercise training significantly improved mitochondrial respiratory capacity by 24.8 ± 6.2% and 27.9 ± 8.7%, respectively (p < 0.05). Fatty acid oxidation and citrate synthase activity were also increased following exercise training by 29.5 ± 6.8% and 19.0 ± 7.4%, respectively (p < 0.05). However, contrary to our hypothesis, heat therapy did not increase fatty acid oxidation or citrate synthase activity. CONCLUSION: Six weeks of muscle-localized heat therapy significantly improves mitochondrial respiratory capacity, comparable to exercise training. However, unlike exercise, heat does not improve fatty acid oxidation capacity.
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Sebők J, Édel Z, Dembrovszky F, Farkas N, Török Z, Balogh G, Péter M, Papp I, Balogi Z, Nusser N, Péter I, Hooper P, Geiger P, Erőss B, Wittmann I, Váncsa S, Vigh L, Hegyi P. Effect of HEAT therapy in patiEnts with type 2 Diabetes mellitus (HEATED): protocol for a randomised controlled trial. BMJ Open 2022; 12:e062122. [PMID: 35820741 PMCID: PMC9277369 DOI: 10.1136/bmjopen-2022-062122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The burden of type 2 diabetes mellitus (T2DM) is increasing worldwide. Heat therapy has been found effective in improving glycaemic control. However, to date, there is a lack of randomised controlled studies investigating the efficacy of heat therapy in T2DM. Therefore, we aim to investigate whether heat therapy with natural thermal mineral water can improve glycaemic control in patients with T2DM. METHODS AND ANALYSIS The HEAT therapy in patiEnts with type 2 Diabetes mellitus (HEATED) Study is a single-centre, two-arm randomised controlled trial being conducted at Harkány Thermal Rehabilitation Centre in Hungary. Patients with T2DM will be randomly assigned to group A (bath sessions in 38°C natural thermal mineral water) and group B (baths in thermoneutral water (30°C-32°C)). Both groups will complete a maximum of 5 weekly visits, averaging 50-60 visits over the 12-week study. Each session will last 30 min, with a physical check-up before the bath. At baseline, patients' T2DM status will be investigated thoroughly. Possible microvascular and macrovascular complications of T2DM will be assessed with physical and laboratory examinations. The short form-36 questionnaire will assess the quality of life. Patients will also be evaluated at weeks 4, 8 and 12. The primary endpoint will be the change of glycated haemoglobin from baseline to week 12. An estimated 65 patients will be enrolled per group, with a sample size re-estimation at the enrolment of 50% of the calculated sample size. ETHICS AND DISSEMINATION The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (818-2/2022/EÜIG). Written informed consent is required from all participants. We will disseminate our results to the medical community and will publish our results in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT05237219.
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Affiliation(s)
- Judit Sebők
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Zsófia Édel
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Institute of Bioanalysis, University of Pecs Medical School, Pécs, Hungary
| | | | | | | | | | - Zsolt Balogi
- Institute of Biochemistry and Medical Chemistry, University of Pecs Medical School, Pécs, Hungary
| | - Nóra Nusser
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary
| | - Iván Péter
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary
| | - Philip Hooper
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Paige Geiger
- Department of Molecular and Integrative Physiology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Bálint Erőss
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - István Wittmann
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | | | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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