If you don’t exercise, you increase your risk of developing type 2 diabetes, an ailment that health officials say has reached epidemic levels. Leann Lesperance is looking for ways to improve the odds against that without anyone breaking a sweat. An assistant research professor of bioengineering in Binghamton University’s Watson School of Engineering and a pediatrician with Binghamton Pediatric Center, Lesperance is leading a team that’s exploring whether micromechanical stimulation to the feet can help improve the way the body uses glucose.
Lesperance joined the faculty at the Watson School in 2004 and also serves as clinical assistant professor of pediatrics at SUNY-Upstate Medical University’s Binghamton Clinical Campus. Along with her M.D., she holds a Ph.D. in medical engineering. She has served as a lecturer at Harvard Medical School and is an editor with Harvard Health Publications/InteliHealth.com. Her current research interests include health care quality and type 2 diabetes.
Unlike patients with type 1 diabetes, many with type 2 do produce insulin, the hormone required to process sugar. But type 2 patients don’t use their insulin effectively. As a result, their cells may become starved for energy, and the buildup of unused glucose over time may damage the eyes, kidneys, nerves and heart.
Together with Ken McLeod, chair of the bioengineering department, and graduate student Anna Spektor, Lesperance is trying to learn whether a device called the Juvent 1000cs can help lower the risk for type 2 diabetes, particularly among people who live sedentary lives. Developed by Juvent, Inc. of Somerset, N.J., the Juvent 1000cs looks something like a bathroom scale. A plate on its surface vibrates at a frequency of 45 Hz. When a subject rests his or her feet on the plate, the vibrations stimulate receptors in the feet, which in turn send signals to the calves, causing the muscles to contract.
It already has been demonstrated that the vibrating plate can help improve cardiovascular function. “The theory is that it’s stimulating your muscles, doing things as if you were standing up and moving around,” said Lesperance. The success of these earlier experiments has led researchers to wonder if the vibrations could take the place of exercise to improve other health factors as well. “And a natural extension of that was to think about diabetes, because we know that exercise improves our blood sugar control.”
Starting in the fall of 2004, Lesperance and her team have recruited women-none of whom have been diagnosed with diabetes-to take two oral glucose tolerance tests. After drinking the glucose solution, the women spend three hours with their feet on a Juvent 1000cs, once with the vibration turned on and once with it turned off.
A tiny, catheter-like sensor, inserted under each subject’s skin, monitors the level of glucose in the blood during both three-hour tests. “We see how high it goes” after the subject drinks the solution “and how fast it goes down,” Lesperance said.
Results from the tests, scheduled to wrap up by June, look encouraging. In at least some of the subjects, “the stimulation is showing a positive effect,” Lesperance said. “I can’t draw any statistically-relevant conclusions at this point, but we’re getting data that suggests that there is some clinical effect to this device on the utilization of glucose by the body.”
Juvent has provided ongoing support to this project. It will also match dollar-for-dollar a $537,000 grant that McLeod received this year from the New York State Office of Science, Technology and Academic Research (NYSTAR) for further work with the Juvent 1000cs.
That research is still in the planning stage, but Lesperance hopes to use several additional techniques to further examine how micromechanical stimulation affects glucose uptake. One proposal is for a long-term study in which subjects would use the vibrating plate during the workday for six months. Researchers would periodically measure a substance called hemoglobin A1C, which reflects the level of sugar in the blood over the previous two to three months.
The team also wants to explore the immediate effects of the vibrating plate, using a positron emission tomography (PET) scan to see how much the calf muscle absorbs a labeled glucose molecule. “We were thinking that we would do one leg on [the device] and one leg off and see if you could see the difference,” Lesperance said. She has talked with a physician at United Health Services in Binghamton about possibly using that institution’s PET scan equipment.
Another proposal is to use equipment at the University Hospital of the State University of New York in Syracuse to conduct a procedure called a euglycemic insulin clamp. This technique allows researchers to control precisely the levels of insulin and sugar in the bloodstream, eliminating any extraneous factors that might affect test results. “We might be able to work out a test where we can learn even more about what’s happening to the whole body glucose uptake during the use of this device,” Lesperance said.
Since exercise improves a whole range of health factors, the Juvent 1000cs might help prevent other medical conditions as well, Lesperance said. Examples are blood clots in the leg, a hazard that afflicts airline travelers, and osteoporosis.
Clearly, the vibrating plate has effects throughout the body, Lesperance said. “The question is going to be, what’s the mechanism, and how do you maximize it?”
