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External Counterpulsation Therapy

May improve conditions for people with type II diabetes mellitus

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External Counterpulsation (ECP) Therapy

LifeCare Diagnostic

November 6, 2020

According to the 2019 National Health and Morbidity Survey (NHMS 2019) done by the Ministry of Health (MOH), the prevalence rate of diabetes in adults has increased in Malaysia from 13.4% in 2015 to 18.3% in 2019.
The rise in the number of diabetes cases in Malaysia is among the worrying findings in the NHMS 2019. About 49% of diabetics in Malaysia have never been screened or diagnosed with the disease. The diabetes prevalence in Malaysia continued to increase without a drop, although our government has given serious attention on this issue. If the prevalence rate keeps increasing, there will be seven million Malaysian adults who are likely to have diabetes by 2025, with 31.3% diabetes prevalence for adults aged 18 years and above.

Type II diabetes is a chronic condition that could affect the metabolism of glucose (sugar) in your body. This is also known as non-insulin-dependent diabetes, in which your body resists the effects of insulin and cannot regulate the movement of glucose between your cells and blood vessels.

People with uncontrolled type II diabetes can lead to chronically high blood glucose levels, causing several symptoms and potentially leading to serious complications such as cardiovascular disease, kidney disease, nerve disease, eye disease or even lead to a higher risk of developing infections.


Type II diabetes is a chronic condition that could affect the metabolism of glucose (sugar) in your body. This is also known as non-insulin-dependent diabetes, in which your body resists the effects of insulin and cannot regulate the movement of glucose between your cells and blood vessels.

People with uncontrolled type II diabetes can lead to chronically high blood glucose levels, causing several symptoms and potentially leading to serious complications such as cardiovascular disease, kidney disease, nerve disease, eye disease or even lead to a higher risk of developing infections.

The ECP Approach

To reduce the risk of these complications, a healthy lifestyle choice is a must. An alternative approach which is known as ECP therapy shows a positive effect on glycemia control. ECP, External Counterpulsation is a mechanical form of treatment that is initially used to treat angina. As ECP therapy increases in popularity, more than 200 peer-reviewed studies have been published on its benefits and safety which suggest that ECP is beyond heart diseases. Of these, studies suggest that in patients with diabetes, ECP can be a safe option for improving glycaemic control.

The ECP Approach

To reduce the risk of these complications, a healthy lifestyle choice is a must. An alternative approach which is known as ECP therapy shows a positive effect on glycemia control. ECP, External Counterpulsation is a mechanical form of treatment that is initially used to treat angina. As ECP therapy increases in popularity, more than 200 peer-reviewed studies have been published on its benefits and safety which suggest that ECP is beyond heart diseases. Of these, studies suggest that in patients with diabetes, ECP can be a safe option for improving glycaemic control.

Benefits of ECP on Type II Diabetes

Improved Glucose Tolerance
ECP has a beneficial effect on glucose tolerance in patients with abnormal glucose tolerance (AGT). In skeletal muscle, improvements in nitric oxide bioavailability by 30% due to the shear stress created by ECP cuffs may stimulate glucose uptake. Besides, researcher J. S. Martin et al. propose that ECP therapy can improve glucose tolerance in patients with type II diabetes. From the experiment, the glucose intake after a meal at 120 min has a significant decrease in the ECP group.

Declination in glucose level has been observed similar to resistance training and aerobic exercise intervention in older men with diabetes. The signalling pathway is improved through the production of nitric oxide, hence facilitating the glucose uptake by the skeletal and cardiac muscle cell.

Improved Fasting Glucose and Insulin Concentrations

ECP treatment has shown a change in fasting glucose and insulin concentrations. People with AGT demonstrated marked improvements in fasting indexes of glycaemic control after the ECP treatment. From a study done by Martin et al., the fasting plasma glucose values were decreased by 17 mg/dl following the ECP treatment.

 

Improved Fasting Glucose and Insulin Concentrations

ECP treatment has shown a change in fasting glucose and insulin concentrations. People with AGT demonstrated marked improvements in fasting indexes of glycaemic control after the ECP treatment. From a study done by Martin et al., the fasting plasma glucose values were decreased by 17 mg/dl following the ECP treatment.

 

Besides, a clinical study done by Paloma et al. have shown the benefits of ECP on glycaemic parameters that improves endothelial function thereby enhancing insulin utilization, as demonstrated by the decrease in insulin resistance and increase in the insulin sensitivity. Moreover, this possible mechanism of action of the effect of ECP on improving insulin resistance in diabetic patients, might be due to the increase in microcirculation (circulation of the blood in the smallest blood vessels due to angiogenesis) and GLUT-4 (a sugar transporter) protein expression in skeletal muscle.

Increased markers of angiogenesis

ECP treatment has shown to increase glucose uptake through enhancing blood circulation, creating a frictional force against the walls of the blood vessel, also known as shear stress. Compression of the ECP cuffs creates several thousand brief, intermittent bouts of shear stress and results in releasing growth factors, which stimulates the growth of blood vessels (angiogenesis). The formation of new blood vessels causes an increase in the number of capillaries, capillaries density, and number of capillaries contacts per muscle fibre. 

Increased markers of angiogenesis

ECP treatment has shown to increase glucose uptake through enhancing blood circulation, creating a frictional force against the walls of the blood vessel, also known as shear stress. Compression of the ECP cuffs creates several thousand brief, intermittent bouts of shear stress and results in releasing growth factors, which stimulates the growth of blood vessels (angiogenesis). The formation of new blood vessels causes an increase in the number of capillaries, capillaries density, and number of capillaries contacts per muscle fibre. 

Studies have shown that ECP therapy significantly increased angiogenesis and the capillary density in skeletal muscle is increased. The increase in blood capillaries could increase the rate of delivery of insulin and glucose uptake to muscle cells, which increase the glucose tolerance.

Conclusion

The result of several studies proves that other than non-diabetic CHD patients, ECP therapy is a safe, beneficial, non-invasive treatment for type II diabetic patients. A significant improvement in fasting glucose and insulin concentrations and significant improvements in glucose tolerance following with ECP therapy has been shown in those studies.
In order to have the improvement, studies suggested the patient should receive ECP therapy for at least 35 sessions and each with 1 hour for 7 weeks. Therefore, through the combination of healthy lifestyle habits such as practicing a healthy dietary pattern and being physically active with this external counterpulsation (ECP) therapy, the effort made to reduce the risk of diabetes-related complications and health conditions could be further improved.

In the ReLive ECP Centre in LifeCare, we have trained and qualified personnel to conduct this non-invasive ECP heart treatment for you. Visit us and experience lifetime health benefits. Grab your complimentary 30-minute therapy trial (worth RM180) now !

For more information, please contact:

Tel: +603-2240 2881
Mobile: +6016-261 2837

Email: ecp@lifecare.com.my

Location: ReLive ECP Centre | Ground Floor, Wisma Life Care,
No 5, Jalan Kerinchi, Bangsar South, 59200 Kuala Lumpur, Malaysia

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