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Acupuncture Helps to Increase Insulin Sensitivity

Electro-acupuncture may be beneficial through different mechanisms: weight loss, anti-inflammatory effects, and improvement of lipid metabolism and adipokines.

Obesity induces insulin resistance (IR), the key etiologic defect of type 2 diabetes mellitus (T2DM). Therefore, an incidence of obesity-induced diabetes is expected to decrease if obesity is controlled. Although metformin is currently one of the main treatment options for T2DM in obese patients, resulting in an average of 5% weight loss, adequate weight control in all patients cannot be achieved with metformin alone. Thus, additional therapies with a weight loss effect, such as acupuncture, may improve the effectiveness of metformin.

One of those therapies is acupuncture, which, when combined with metformin, showed a loss in weight and increase in insulin sensitivity.

Acupuncture is one of the oldest healing practices and is recognized by the National Institute of Health and the World Health Organization. According to the theory of traditional Chinese medicine, acupuncture regulates ‘Qi and Blood’ and is likely to affect the bioavailability of substances taken internally and, in the process, may influence the absorption, distribution, metabolism and/or excretion of substances. The effect of acupuncture on T2DM, obesity, plasma free fatty acids (FFAs) level and on insulin sensitivity has been addressed in experimental and clinical studies. Two groups were used, both getting metformin and only one group received acupuncture as the other group was getting sham treatments. All participants were treated 10 times every other day, for a total duration of 3 weeks. In the case group, enrolled participants were treated with metformin monotherapy and received EA (electro-acupuncture), and Auricular acupuncture (Aa), at the selected acupoints.

Participants in the acupuncture group experienced reductions from baseline in both body weight (82.6 kg to 78.4 kg; P < .001) and BMI (27.6 kg/m² to 26.2 kg/m²; P < .001) at 3 weeks. Similarly, fasting blood glucose improved for those assigned acupuncture (6.65 mmol/L to 6.12 mmol/L), as did fasting insulin (14.47 µIU/mL to 9.91 µIU/mL), and HOMA-IR also fell in the acupuncture group (4.25 to 2.67; P < .001). No significant changes from baseline were found in the sham-procedure group.

The average ages of our 39 participants were 42.2 in the case group and 40.5 in the control group. Eight members of the case group were male and 11 were female. In the control group, eight members were male and 12 were female. No statistical difference in sex or age was observed among these case and control groups.

Participants in the acupuncture group also saw reduced free fatty acids, plasma triglycerides, LDL cholesterol and an increase in HDL cholesterol, as well as reduced ceramide levels. Tumor necrosis factor-alpha, interleukin-6, glucagon-like peptide-1 and leptin levels all were reduced in the acupuncture group. No significant differences for C-reactive protein levels were found for either group, according to researchers. As this was a small study of 16 men, hopefully it will lead to larger studies.

There was a significant difference in changes, in leptin levels between the two groups (P<0.001), and leptin levels were significantly reduced only in the case group (from 13.32±0.2 ng ml−1 before treatment to 10.84±0.4 ng ml−1 after treatment, P<0.001).

The changes in body weight and BMI in this study prove that acupuncture-combined therapy is efficient in achieving weight loss. However, the mechanism of EA in weight loss remains in question. It is thought that acupuncture exerts its effects on weight loss through different mechanisms, such as reducing hunger, affecting lipid and carbohydrate metabolism, affecting activity of glucose-inhibited neurons and modulating feeding behavior.

Consequently, metformin and acupuncture combined therapy is more effective than metformin only, proving that acupuncture is an insulin sensitizer and is able to improve insulin sensitivity possibly by reducing body weight and inflammation, while improving lipid metabolism and adipokines. As a result, electro-acupuncture (EA) might be useful in controlling the ongoing epidemics in obesity and T2DM.

Practice Pearls:

  • Acupuncture is one of the oldest healing practices and is recognized by the National Institute of Health and the World Health Organization.
  • There was also a significant difference in changes in leptin levels.
  • The results showed that metformin and acupuncture combined therapy significantly improves body weight, body mass index (BMI), fasting blood sugar (FBS), fasting insulin (FINS), homeostasis model assessment (HOMA) index plus improved cholesterol levels.

Firouzjaei A, et al. Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients. Nutr Diabetes. 2016;doi:10.1038/nutd.2016.16.