Background:
Enhanced external counterpulsation (EECP) is a non-invasive treatment that has been shown to be an effective means of improving angina and functional capacity in patients with symptomatic coronary artery disease who are not candidates for percutaneous or surgical revascularization. The therapy involves a series of pneumatic cuffs that are wrapped around the calves, thighs and buttocks, which inflate and deflate rhythmically with the cardiac cycle. EECP is reported to increase venous return, potentially enhancing angiogenesis and collateral circulation. Although a large number of patients undergoing EECP therapy have a history of either insulin dependent diabetes mellitus (IDDM) or non-insulin dependent diabetes mellitus (NIDDM), few data are available regarding the acute effect of EECP on blood glucose values.
Methods:
15 patients referred for EECP therapy (35 hours over several weeks) with IDDM or NIDDM were asked to participate. In the second or third week of EECP therapy, a sampling treatment session was chosen and patients were asked not to consume any food or drink (other than water) for 2 hours prior to treatment. Capillary blood glucose values were obtained immediately prior to, immediately after and 30 minutes following one 60 minute session of EECP therapy.
Results:
Mean +/- SD and median values of blood sugar values before (pre), immediately after (post) and 30 minutes after completion of the EECP session are shown in the table below:
Compared with the pre-therapy blood sampling, post-treatment glucose values decreased decrementally thereafter.
Conclusion:
Our findings indicate that blood glucose in symptomatic coronary patients with IDDM or NIDDM decreases following 60 minutes of EECP therapy and continues to decline 30 minutes later. These results suggest that EECP treatment, like aerobic exercise, has an "insulin-like effect" by transiently reducing elevated blood glucose levels. The chronic effect of EECP therapy on blood glucose levels remains unclear.