Effect of Neuromuscular Electrical Stimulation on Glycemic Control in a Population with Hyperglycemia

Hyperglycemia in people with prediabetes and diabetes, if left untreated, can cause serious health conditions. Voluntary muscle contraction (exercise) is known to increase glucose uptake into cells, thereby improving glycemic control. Nonetheless, adherence to conventional exercise is low. Neuromuscular electrical stimulation (NMES) involuntarily contracts skeletal muscle; however, the effectiveness of NMES on glycemic control is not clear. The purpose of this study was to determine the effect of acute and 8 weeks of NMES on glycemic control in people with hyperglycemia. We hypothesized that NMES will improve glycemic control by reduction of blood glucose (acute effect) and improvement in glucose tolerance (chronic effect). METHODS: Thirty-four sedentary participants (Age: 39.8±12.6 years; BMI: 36.2±6.2 kg/m2) with hyperglycemia (fasting glucose ≥ 100 ug/dL or 2-hour post-glucose load ≥ 140ug/dL) were recruited for the study. Participants’ fasting blood glucose, substrate utilization (respiratory exchange ratio (RER)), and energy expenditure were measured right before and continuously during 30 minutes of NMES. A subset of participants (n=20) was randomized into control (n=9) or NMES groups (n=11) for an 8-week intervention to receive supervised bilateral quadriceps stimulation (30 minutes/session; 3 times/week at 50 Hz and 300 µs pulse width) at a low intensity sensory level or at a high intensity neuromuscular level respectively. Glycemic control was measured using oral glucose tolerance test (OGTT) before and after the intervention. Body composition was measured using DXA. Data were analyzed using paired t-test and two-way ANOVA with repeated measures and Sidak post hoc analysis. Results: Thirty minutes of NMES (acute effect) resulted in significant reduction of fasting blood glucose (110.2±3.4 mg/dL to 107.1±2.9 mg/dL; p<0.01), increase in RER (0.77±0.01 to 0.79±0.01; p<0.01) and no change in energy expenditure (p>0.05) during the stimulation compared to baseline. Eight weeks of NMES intervention (chronic effect) resulted in reduction of blood glucose levels at the 90, 120, and 150 minutes of the OGTT test (p<0.05 at each time points). Glucose tolerance significantly improved after 8 weeks of NMES intervention as assessed by 3-hour glucose area under the curve (AUC) (506.3±32.6 AU to 476.3±27.0 AU; p<0.05) whereas control group exhibited no significant changes at any timepoint during OGTT (p>0.05) nor the 3-hour AUC (513.4±36.8 AU to 494.7±43.6 AU; p>0.05). Body composition measured by total mass, total fat mass, and total lean mass did not change for either group (p>0.05). CONCLUSION: Involuntary muscle contraction through NMES is a potential strategy for blood glucose management in people with hyperglycemia. Future studies should evaluate the feasibility and adherence of NMES administration among people with diabetes. This work is supported by the NIH and by the SURF program funded by the American Physiological Society. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.