Clinical Abstracts

Diabetic? Get Thee to a Hot Tub

With Comments by Adriane Fugh-Berman, MD

Source: Hooper PL. Hot tub therapy for type 2 diabetes mellitus. N Engl J Med 1999;341:924-925.

Design/Setting/Subjects: Open pilot study of eight patients (including three women) ages 43-68 with type 2 diabetes mellitus. Diet, exercise routines, and medications were stable for eight weeks before and during the study.

Treatment: Immersion up to the shoulders in a hot tub (37.8° C-41.0° C) at an athletic facility six days a week for three weeks.

Outcome Measures: Plasma glucose, glycosylated hemoglobin, weight.

Results: Mean fasting plasma glucose levels decreased significantly from 182 ± 37 mg/dl to 159 ± 42 mg/dl. Mean glycosylated hemoglobin decreased significantly from 11.3 ± 3.1% to 10.3 ± 2.6%. After 10 days, one patient reduced his dose of insulin by 18%. Weight did not decrease significantly (a mean of 1.7 ± 2.7 kg). Oral temperature increased an average of 0.8° C. Some subjects reported increased well being and improved sleep as the study progressed.

Funding: Not stated.

Comments: We have run several articles recently on the benefits of exercise, so let’s give vegging out equal time. I love the idea that lolling about in a hot tub may provide some of the same benefits as exercise. However, 30 minutes in a hot tub is a long time. Patients in this study complained of feeling hot when the water temperature was higher than 40° C and became dizzy on exiting the tub, so were routinely helped from the tub and seated for a while after each session. I wonder what their blood pressure and electrolytes looked like. Still, the results of this small pilot study are interesting and warrant a larger study. But next time, it would be a good idea to test the effect of shorter periods of time, and monitor blood pressure, heart rate, and electrolytes.