Acute mild cold exposure with shivering reduces 24 h glucose levels in individuals with type 2 diabetes but not prediabetes
Hashim D, Jörgensen JA, van de Weijer T, Blondin DP, Schrauwen P, Hoeks J
Diabetologia · 0 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- ZonMw
- Universidad u hospital
- Universiteit Maastricht
- Organización sin fines de lucro
- European Association for the Study of Diabetes
- Universidad u hospital
- NUTRIM School of Nutrition and Translational Research in Metabolism
- Subvenciones
- ZonMw (09120012010062)
Según 4 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-07-20 · Diabetologia · vol. 69 · número 10 · págs. 2922–2937
- Editorial
- Springer Science+Business Media
- Citado
- 0 citas · más que el 55% de estudios similares · 0.0× el promedio de su campo
- Referencias
- 46 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY
- Áreas de investigación
- Adipose Tissue and Metabolism · Diabetes Management and Research · Thermal Regulation in Medicine
- Palabras clave
- cold exposure, shivering, type 2 diabetes, prediabetes, glucose homeostasis, glucose metabolism, resting metabolic rate, energy expenditure, fasting blood glucose, hyperglycemia, continuous glucose monitoring, water-perfused suit, cold-induced thermogenesis
- MeSH
- humans, diabetes mellitus, type 2, prediabetic state, blood glucose, cross-over studies, energy metabolism, shivering, adult, aged, middle aged, female, male, cold temperature, continuous glucose monitoring
6 autores
- Dzhansel Hashim🇳🇱Maastricht University
- Johanna A. Jörgensen🇳🇱Maastricht University
- Tineke van de Weijer🇳🇱Maastricht University Medical Centre
- Denis P. Blondin🇨🇦Université de Sherbrooke; Centre Hospitalier Universitaire de Sherbrooke
- Patrick Schrauwen🇳🇱🇩🇪Leiden University; Leiden University Medical Center; Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Joris Hoeks J🇳🇱 · autor de correspondenciaMaastricht University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aims/hypothesis
Repeated cold exposure with shivering has been proposed as a potential strategy to enhance glucose metabolism by increasing energy expenditure and substrate utilisation. However, acute effects/benefits of cold-induced shivering on glucose homeostasis in metabolically compromised individuals are unknown. Here, we aimed to determine whether cold exposure at two different intensities improves 24 h glucose homeostasis in individuals with prediabetes and type 2 diabetes.
Methods
In a randomised crossover trial conducted in the South Limburg/Maastricht region of the Netherlands, men and postmenopausal women with prediabetes (n=12) and stable type 2 diabetes (n=12), aged 40-75 years, body mass index ≥27 and ≤35 kg/m2, non-smoking and sedentary, underwent two whole-body cold exposure sessions using a water-perfused suit. Session order was randomised using an online randomisation tool (randomizer.org); participants were masked to the cold exposure intensity received, but investigators were not. Sessions were designed to elicit ~1.5-fold (mild, 15°C) and ~2.5-fold (moderate, 4°C) increases in resting metabolic rate (RMR). Continuous glucose monitoring assessed interstitial glucose concentrations over 24 h periods before and after each intervention, with controlled diet and activity. Shivering was confirmed via indirect calorimetry and electromyography.
Results
In both study groups and periods, RMR increased significantly vs baseline (p<0.001 for all). In prediabetes, the increase in the final 1 h of cold was 1.53 × RMR in mild and 1.94 × RMR in moderate cold. In type 2 diabetes, the increase was 1.57 × RMR and 2.09 × RMR in the final 1 h of mild and moderate cold, respectively. In prediabetes, neither mild nor moderate cold exposure altered mean 24 h glucose levels. In contrast, after mild cold exposure the type 2 diabetes group exhibited a significant reduction in mean 24 h glucose levels (-0.6 ± 0.5 mmol/l, p=0.003) and fasting glucose (-0.6 ± 0.8 mmol/l, p=0.019), as well as an increase in time in normal range (+8.8 ± 10.3%, p=0.013) and reduced time in hyperglycaemia (-10.9 ± 12.9%, p=0.014). Moderate cold did not significantly affect any of the glucose outcomes in type 2 diabetes. Baseline fasting glucose, age and ALT levels were predictors of the glucose-lowering response, suggesting greater benefits in individuals who have higher baseline glucose levels, are younger and/or have more optimal liver health, i.e. lower ALT.
Conclusions/interpretation
Acute mild cold exposure with shivering reduced 24 h glucose levels in individuals with type 2 diabetes. No changes were observed in prediabetes. The observed effects appear to depend on baseline metabolic status rather than acute substrate utilisation during cold exposure. These findings support the potential of cold exposure as an adjunct non-pharmacological therapy for type 2 diabetes, although further mechanistic studies and validation in larger cohorts are warranted.
Trial registration
ClinicalTrials.gov NCT05576025 FUNDING: Dutch Organisation for Knowledge and Innovation in Health, Healthcare and Well-being (ZonMw): 09120012010062.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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