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Cryotherapy for Diabetes: Hope or Hype?

Researchers are exploring the benefits of cryotherapy, an alternative therapy where the body is exposed to freezing or near-freezing temperatures like an ice bath or cold plunge. Though evidence is scarce, cold therapy is suggested to be another way to burn calories and lower blood sugar faster in people with diabetes.

You already know how important exercise is for increasing insulin sensitivity and lowering blood glucose. But what if you could have the same fat-burning, A1C-lowering effects without the exercise?

If that sounds too good to be true, it probably is. However, researchers are exploring cold exposure therapy as a new way to burn more calories and lower blood sugar faster in people with diabetes. To your body, cold exposure can mimic the effects of exercise, instigating short-term changes like turning up the heat in your fat cells and burning off excess calories. 

But before you book the next flight to Alaska or plop into an ice water bath, there's a lot we don't know about real-world applications of cryotherapy or cold exposure – especially for people with diabetes. Here's what you need to know. 

What is cold exposure therapy?

Cold exposure therapy involves subjecting yourself to cold temperatures for short periods of time. At home, you can use cold water or air. In the lab, researchers apply cryotherapy, using a vest or a suit that circulates near freezing to freezing water.

Cold therapy, especially water immersion such as winter swimming and ice baths, has been claimed to improve: 

  • Circulation
  • Depression and stress
  • Inflammation

However, the scientific evidence for many of these claims is shaky, hampered by small sample sizes, poor study design, and lack of funding to conduct larger studies, according to researchers. 

Potential benefits of cryotherapy

In general, there needs to be more research before scientists can reach a conclusion regarding cold therapy and diabetes. One small study had participants with type 2 diabetes sit in a cold room at 57-59 degrees Fahrenheit for up to three hours for 10 days straight. On day 11, researchers found insulin sensitivity increased by an average of 43%, which was higher than improvements usually seen with long-term exercise.

Exercise is helpful for people with diabetes because it helps maintain a healthy weight. Cold therapy may be viewed as equivalent to low-intensity exercise as shivering induces muscles to contract as they would during physical activity. This shivering or muscle contraction effect also appears to be helpful in lowering blood glucose. 

With cold exposure, some normal fat cells may be induced to turn brown or beige, said Dr. Phillip Kern, an associate professor of endocrinology at the University of Kentucky College of Medicine. Brown fat is loaded with mitochondria, the powerhouses inside cells that provide them with energy. Not only does this gives cell a brownish or beige appearance, but the mitochondria turns cells into energy-burning, heat-generating machines. 

Barriers to cold exposure therapy

One downfall of cold exposure therapy is the effects are temporary. That, and you have to be ready to brave the cold.

“People don’t like to be cold,” said Kern. “The question is, how can you deliver enough cold to make a difference without it being too uncomfortable?”

There are also issues of safety. Cold water is the most accessible method outside a clinical setting, but it can be dangerous. When you jump into frigid water, there’s a cold shock response that results in gasping and hyperventilation. 

As for whole-body cryotherapy chambers, the U.S. Food and Drug Administration (FDA) notes that no device on the market is FDA-approved, and to treat any suggested benefits with caution. 

“There are all kinds of claims of improving diseases, but it’s all totally anecdotal,” said Kern. The American Academy of Dermatology also recommends against cryotherapy chambers because they can be harmful to your skin. Cryotherapy chambers are often by athletes to assist with recovery and usually uses liquid nitrogen for cooling. An alternative option is an ice water bath.

With all these strikes against it, cryotherapy may not be ready for prime time. But the mechanism behind cold therapy is what may make it even more exciting than the treatment itself. 

“If you could figure out how to turn white fat into brown fat in a novel way, such as a drug activating your sympathetic nervous system [to stimulate adrenaline], that might be an interesting way to go,” said Kern. 

In fact, Kern said, there’s already a drug on the market that he and others are studying for this purpose. It’s called Myrbetriq (mirabegron) and is used to treat overactive bladder. “This drug stimulates adrenaline receptors, but it doesn’t stimulate the adrenaline receptors that are in the heart – only in fat and the smooth muscle of the bladder,” said Kern. 

For now, cold therapy for diabetes will likely remain an unproven novelty until more studies are done and it’s more accessible. As researchers ask and answer more questions, it’s possible that cold therapy may eventually emerge as a complementary part of a diabetes management plan.

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