Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2022; 130(01): 17-21
DOI: 10.1055/a-1525-3339

Article

Influence of Spinal Cord Stimulation on Insulin Sensitivity in Chronic Pain Patients

Matthias H. Morgalla

¹Neurosurgical Clinic, University of Tübingen, Tübingen, Germany

,

Hannah Fritschle

¹Neurosurgical Clinic, University of Tübingen, Tübingen, Germany

,

Andreas Vosseler

²Medical Clinic IV, University of Tübingen, Tübingen, Germany

³Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany

⁴German Center for Diabetes Research (DZD), Neuherberg, Germany

,

Charlotte Benkendorff

²Medical Clinic IV, University of Tübingen, Tübingen, Germany

,

Apostolia Lamprinou

²Medical Clinic IV, University of Tübingen, Tübingen, Germany

³Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany

⁴German Center for Diabetes Research (DZD), Neuherberg, Germany

,

Martin Heni

²Medical Clinic IV, University of Tübingen, Tübingen, Germany

³Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany

⁴German Center for Diabetes Research (DZD), Neuherberg, Germany

,

Andreas Fritsche

²Medical Clinic IV, University of Tübingen, Tübingen, Germany

³Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany

⁴German Center for Diabetes Research (DZD), Neuherberg, Germany

› Author Affiliations

Abstract

Background and Objective This prospective, sham-controlled, randomized, cross-over study (NCT03637075), was designed to test the hypothesis that spinal cord stimulation (SCS) for the treatment of pain can also improve glucose metabolism and insulin sensitivity when compared to sham stimulation.

Methods Ten non-diabetic participants (5 females, mean age 48.8 years) who had an SCS system implanted for the treatment of chronic neuropathic pain were studied. Whilst applying a hyperinsulinemic-euglycemic clamp, sham-stimulation and tonic stimulation were performed for 45 min (n=4) or 60 min (n=6) in each case randomly. The insulin sensitivity index and pain levels were determined. A second investigation, BurstDR stimulation was also conducted and the result was compared to that of sham stimulation (cross-over design).

Results The insulin sensitivity improved significantly under the tonic stimulation when compared to the sham stimulation (p=0.037). BurstDR stimulation independently did not lead to a significantly improved insulin sensitivity compared to that after sham stimulation (p=0.16). We also examined the pain during the test and found no significant difference between sham and tonic stimulation (p=0.687).

Conclusion The results of this study show that tonic stimulation used for the treatment of pain could also improve glucose metabolism and insulin sensitivity. Further investigations are required to investigate the clinical relevance of the role of glucose metabolism in diabetic chronic pain participants and its underlying mechanisms.

Key words

Key words

glucose level - tonic stimulation - BurstDR stimulation - neuropathic pain - sympathetic nervous system - insulin

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