Acupuncture aids weight loss and reduces blood sugar levels in type 2 diabetes patients. Sanming County Hospital of Integrated Medicine researchers (Fujian) conducted a clinical trial of obese patients newly diagnosed with type 2 diabetes. They conclude that acupuncture treatment in addition to routine care is more effective in promoting healthy weight loss and improved blood chemistry than routine care monotherapy. [1]
A total of 124 patients newly diagnosed with type 2 diabetes were randomly assigned to receive either acupuncture plus routine care or routine care alone. The acupuncture group was comprised of 36 male and 26 female patients with a mean age of 60.8 years and a mean BMI (body mass index) of 29.8. The control group was comprised of 38 male and 24 female patients with a mean age of 61.5 and a mean BMI of 29.7.
For inclusion in the study, patients were required to meet the WHO (World Health Organization) diagnostic guidelines for type 2 diabetes, have been diagnosed within the past month, have received no other treatments for diabetes, and have a BMI over 28. Exclusion criteria were stress related complications, serious kidney or liver dysfunction, blood pressure over 160/100 mmHg, glycated hemoglobin levels over 8.6%, and fasting glucose levels over 10 mmol/L. All patients were approved for the study by the hospital ethics committee and gave informed consent to participate.
Routine Care
All participants received routine care for diabetic patients including the first-line antidiabetic drug metformin (one tablet daily) and lifestyle advice. Recommended lifestyle changes included reducing calorie intake by approximately half, over the course of three months. Food intake was reduced gradually by approximately one fifth during the first month, and another one fifth during the second and third months.
Patients were encouraged to increase their physical activity levels, beginning with 15 minutes of walking, three times each week during the first month. During the second and third months, this was increased to 30 minutes of walking, twice a day, five times each week.
Acupuncture
Participants allocated to the acupuncture group received routine care plus acupuncture treatments, with acupoints selected according to each patient’s individual situation. Acupoints were selected from the following list:
- Zhongwan (CV12)
- Taixi (KD3)
- Taiyuan (LU9)
- Shenshu (BL23)
- Yishu (extra point)
- Pishu (BL20)
- Ganshu (BL18)
- Geshu (BL17)
- Sanyinjiao (SP6)
- Zusanli (ST36)
- Hegu (LI4)
- Dazhui (GV14)
The researchers chose one extra point (Yishu), shown in the list above. Yishu (Weiguanshu) is the back shu point of the pancreas and is located 1.5 cun lateral to the midline between the eighth and ninth thoracic vertebrae. This compliments other back shu point selections used in the study.
With patients in a supine position, 1.5 cun (28 gauge) needles were selected for Sanyinjiao, Zusanli, and Zhongwan and 1.5 cun (30 gauge) needles were selected for Taixi and Taiyuan. Needles were inserted and manipulated using a lifting and thrusting technique to obtain deqi, before twisting and rotating using a balanced reinforcing-reducing technique for two minutes. Needles were retained for 30 minutes, with further stimulation administered once or twice during that period.
Patients then changed to a prone position and 1.5 cun (30 gauge) needles were selected for the remaining acupoints. Needles were inserted obliquely toward the spine at a 45-degree angle and, after obtaining deqi, were manipulated using a twisting-rotating, balanced reinforcing-reducing technique for two minutes. Needles were retained for 30 minutes, with further stimulation administered once or twice during that period. Treatment was administered daily, with 20 days making up one course of care. A total of three courses were administered, separated by a ten-day break each time.
Results
Outcome measures for the study included total weight loss and blood chemistry assays, including fasting glucose, glycated hemoglobin, and fasting insulin levels. The total efficacy rate was calculated for each group.
Mean baseline BMI was 29.8 in the acupuncture group and 29.7 in the control group. By the end of the study, both groups saw reductions in BMI to 24.67 in the acupuncture group and 28.17 in the control group. Although weight loss was statistically significant for both groups (p<0.05), reductions were significantly greater in the acupuncture group (p<0.05).
Mean baseline fasting glucose was 8.3 mmol/L in the acupuncture group and 8.2 mmol/L in the control group. At the end of the study, both groups’ fasting glucose levels reduced, to 6.2 mmol/L in the acupuncture group and 7.5 mmol/L in the control group. Both groups saw significant improvements (p<0.05), but these were significantly greater in the acupuncture group (p<0.05).
Mean baseline glycated hemoglobin was 7.6% in both groups. By the end of the study, both groups’ fasting glycated hemoglobin levels decreased, to 6.4% in the acupuncture group and 7.0% in the control group. Both groups saw significant improvements (p<0.05), but these were significantly greater in the acupuncture group (p<0.05).
Mean baseline fasting insulin was 19.8 mIU/L in the acupuncture group and 19.2 mIU/L in the control group. Following treatment, fasting insulin levels fell in both groups, to 10.3 mIU/L in the acupuncture group and 16.4 mIU/L in the control group. Both groups saw significant improvements (p<0.05) and these were significantly greater in the acupuncture group (p<0.05).
The total efficacy rate was calculated for each group. Patients with fasting glucose levels under 7 mmol/L and glycated hemoglobin under 7% were classified as cured. In patients with fasting glucose levels of 7–10 mmol/L and glycated hemoglobin levels of 7–8%, the treatment was classified as effective. For patients with no change in their condition, the treatment was classified as ineffective. The cured and effective rates were added together to give the total effective rates.
In the acupuncture group, there were 30 cured, 28 effective, and 4 ineffective cases, giving a total effective rate of 58 (93.55%). In the control group, there were 22 cured, 26 effective, and 14 ineffective cases, giving a total effective rate of 48 (77.42%). Acupuncture was found significantly more effective than routine care monotherapy (p<0.05).
The results of this study indicates that acupuncture not only increases weight loss in obese diabetes patients, but also stabilizes blood glucose and insulin levels. This indicates that acupuncture is a valuable adjunct to routine care for patients newly diagnosed with type 2 diabetes.
Reference:
1. Cai Shuhang (2018) “Therapeutic effect of acupuncture on new type 2 diabetes with obesity patients” Diabetes New World (September 2018) pp.9-11.
