Acupuncture has been practiced for thousands of years in China to treat a wide variety of diseases, including diabetes. It this section we discuss the literature concerning acupuncture studied in patients with diabetes mellitus.

Acupuncture originated in China over 2000 years ago. Acupuncture derives from the Latin words ‘Acu’ (needle) and ‘Punctus’ (to puncture)[1]. Needling takes place at specific points, acupuncture points, to regulate the ‘Qi’ circulation. There are about 400 acupuncture points and 20 meridians connecting most of the points [2]. It is believed that by stimulating of a selection of these acupuncture points the Qi circulation will get in motion, resulting in the recovery of the Qi and subsequently body functions [1][3].

Besides acupuncture with needling, a variety of acupuncture therapies are described; e.g. electroacupuncture (EA), moxibustion, laser acupuncture, auriculoacupuncture, acupressure, and cupping [1]. With EA, the same acupuncture points are stimulated, however with the addition of administering electric pulses [4]. Moxibustion is a technique that applies heat to acupoints by burning compressed powdered herbal material [5]. With Laser acupuncture, the stimulation of traditional acupuncture points is done with low power lasers [6]. Auriculoacupuncture means ear acupuncture; needling takes place at ear points [7]. With acupressure, acupoints are stimulated by pressure instead of needles [8]. And finally, cups with vacuum are used on acupressure point with cupping [9].

We only describe acupuncture with needling and electroacupuncture, because this techniques are predominantly described in literature regarding to diabetes.


First, the Cochrane library was searched for a meta-analysis on acupuncture and diabetes. One protocol was published to assess the effects of acupuncture in patient with type 2 diabetes mellitus [10]. Unfortunately, the results of this meta-analysis are not published at the time of this publication. Also, no records were found in the TRIP database and on clinical evidence. On Pubmed, several reviews have discussed the effects of acupuncture in diabetes. One review described three studies; these studies showed significant decrease of fasting blood glucose, and oral glucose tolerance in patients with diabetes treated with acupuncture. Increased anaerobic cellular glucose metabolism, changes in insulin-dependent regulation, and increase of insulin sensitivity are mentioned to be the explanation for the improvement of the blood glucose values [3]. A review published about EA for control of blood glucose in diabetes described the hypoglycemic effect of EA in mainly animal studies [4].

Besides reviews about the effect of acupuncture on glucose metabolism, also reviews about diabetic complications were published [11][12][13]. A review about manual acupuncture and diabetic peripheral neuropathy, described a beneficial effect of manual acupuncture for diabetic peripheral neuropathy, but because of the poor methodology of the included randomized clinical trials, no clinical relevant conclusions can be drawn from this review [11]. Also, a meta-analysis regarding the effect of acupuncture and diabetic gastroparesis was published [13]. All studies were assessed by the GRADE system and were assessed as low and very low quality. Because of the low methodological quality of the included trials no definite conclusion on the effect of acupuncture on diabetic gastroparesis could be drawn. A study that assessed the quality of reports regarding acupuncture treatment and diabetic peripheral neuropathy showed that in almost every randomized controlled trial the description of methods and design were incomplete [12].

An electronic search using PubMed (19 June 2015) identified 350 publications a. A total of 18 abstracts [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] were selected, of which 7 studies [19][23][24][26][28][29][30] were written in the Chinese language. As only one English abstract was available of these Chinese publications, assessing methodology of most of these articles was not feasible. A small number of studies were performed on humans; most studies were performed on animals. Finally, most studies described only EA instead of manual acupuncture.

Different animal studies (rats) investigated the role of acupuncture on plasma glucose levels [14][16][19][21][25]. All of these studies described a decrease of blood glucose levels after treatment with EA. A possible explanation mentioned is the enhanced secretion of β-endorphin stimulated by EA, which causes increased secretion of insulin and a decrease of blood glucose levels [14]. Because we are mainly interested in the effects of acupuncture in diabetic patients we will describe the human studies more elaborate.

Only a few studies investigated the effect of acupuncture on plasma glycosylated hemoglobin (HbA1c) in humans [17][23][24][26]. All of these studies applied the acupuncture on different acupoints. Two studies described the effect of EA on HbA1c, and both reported beneficial effects [23][24]. The study by Meng et al, amongst 120 outpatients with impaired glucose tolerance, investigated EA in a randomised study. They investigated the clinical efficacy of EA at different frequencies; the patients were randomly divided into control, EA-5 Hz, EA-50 Hz, and EA-100 Hz groups for 60 sessions. It is unknown which intervention was performed in the control group. Fasting blood glucose and HbA1c were detected during the study. HbA1c was significantly lower in the EA-5 Hz group than those of the control group (P<0.05) and also significant lower than those of pre-treatment in the same group (P<0.01) [23]. In another study by Meng et al, amongst patients with impaired glucose tolerance, EA versus a control group without intervention were randomly divided and the effect of EA on HbA1c and fasting glucose was investigated. HbA1c was down-regulated in the EA group and superior to the control group after 6 sessions of EA [24]. Methodology and results were only described in Chinese, therefore only an English abstract was checked. No information regarding baseline characteristics, results and statistics were available.

Complications of Acupuncture

Inadequate sterilization of needles or inadequate treatment can cause local pain, inflammation, hematoma or infection [32][33]. Minor and major adverse events have been described. In a German study published in 2004, although the prevalence is low, the most frequent mentioned serious adverse event was a pneumothorax (no. 2 out of 97.733 patients). In this study needling pain and hematoma during treatment were most common seen, respectively 3.28% and 3.19% [32]. In immunocompromised or poorly controlled diabetic patients very rare major complication like necrotizing fasciitis, abscess formation, and bacteremia were described in case-reports [3][34][35][36][37].


Different studies, mostly animal studies, showed beneficial effect of acupuncture on blood glucose or HbA1c. However, it is not possible to draw any definite conclusions as only abstracts were available or studies had a poor methodological quality. Well-designed randomized controlled trials are needed to draw definitive conclusions regarding the effect of acupuncture on diabetes.


  1. ^ Nederlandse patienten vereniging voor acupuncture. [June 2015]; Available from:

  2. ^ Pumthong G et al. Complementary and alternative medicines for diabetes mellitus management in ASEAN countries. Complementary therapies in medicine. 2015 Aug;23(4):617-25.

  3. ^ Liang F, Koya D. Acupuncture: is it effective for treatment of insulin resistance? Diabetes, obesity & metabolism. 2010 Jul;12(7):555-69.

  4. ^ Peplow PV, Baxter GD. Electroacupuncture for control of blood glucose in diabetes: literature review. Journal of acupuncture and meridian studies. 2012 Feb;5(1):1-10.

  5. ^ Su YS et al. Effects of Different Local Moxibustion-Like Stimuli at Zusanli (ST36) and Zhongwan (CV12) on Gastric Motility and Its Underlying Receptor Mechanism. 20150806 DCOM- 20150806(1741-427X (Print)).

  6. ^ de Oliveira RF, da Silva CV, Cersosimo MC, Borsatto MC, de Freitas PM. Laser therapy on points of acupuncture: Are there benefits in dentistry? 20150719(1873-2682 (Electronic)).

  7. ^ Hu H. A review of treatment of diabetes by acupuncture during the past forty years. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan / sponsored by All-China Association of Traditional Chinese Medicine, Academy of Traditional Chinese Medicine. 1995 Jun;15(2):145-54.

  8. ^ Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: A randomised controlled trial. 20150608(1873-6963 (Electronic)).

  9. ^ Mehta P, Dhapte V. Cupping therapy: A prudent remedy for a plethora of medical ailments. 20150707 DCOM- 20150707(2225-4110 (Electronic)).

  10. ^ Shen W LY et al. Acupuncture for adults with type 2 diabetes mellitus (Protocol). The Cochrane Library. 2013(4).

  11. ^ Chen W et al. Manual acupuncture for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials. PloS one. 2013;8(9):e73764.

  12. ^ Bo C et al. Assessing the quality of reports about randomized controlled trials of acupuncture treatment on Diabetic Peripheral Neuropathy. 20120706 DCOM- 20121113(1932-6203 (Electronic)).

  13. ^ Yang M et al. Meta-analysis of acupuncture for relieving non-organic dyspeptic symptoms suggestive of diabetic gastroparesis. BMC complementary and alternative medicine. 2013;13:311.

  14. ^ Chang SL et al. An insulin-dependent hypoglycaemia induced by electroacupuncture at the Zhongwan (CV12) acupoint in diabetic rats. Diabetologia. 1999 Feb;42(2):250-5.

  15. ^ Figueiredo LM et al. Electroacupuncture stimulation using different frequencies (10 and 100 Hz) changes the energy metabolism in induced hyperglycemic rats. Acta cirurgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia. 2011;26 Suppl 1:47-52.

  16. ^ Ishizaki N et al. Improvement in glucose tolerance as a result of enhanced insulin sensitivity during electroacupuncture in spontaneously diabetic Goto-Kakizaki rats. Metabolism: clinical and experimental. 2009 Oct;58(10):1372-8.

  17. ^ Li G et al. The short-term effects of acupuncture on patients with diabetic gastroparesis: a randomised crossover study. Acupuncture in medicine : journal of the British Medical Acupuncture Society. 2015 Jun;33(3):204-9.

  18. ^ Li S et al. Therapeutic effect of vagus nerve stimulation on depressive-like behavior, hyperglycemia and insulin receptor expression in Zucker fatty rats. PloS one. 2014;9(11):e112066.

  19. ^ Li YY et al.[Effects of electroacupuncture stimulation of "Daimai" (GB 26) on body weight, blood glucose and blood lipid levels in rats with metabolism syndrome]. Zhen ci yan jiu = Acupuncture research / [Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 2014 Jun;39(3):202-6.

  20. ^ Liang F et al. Low-Frequency Electroacupuncture Improves Insulin Sensitivity in Obese Diabetic Mice through Activation of SIRT1/PGC-1alpha in Skeletal Muscle. Evidence-based complementary and alternative medicine : eCAM. 2011;2011:735297.

  21. ^ Lin RT et al. Electroacupuncture improves glucose tolerance through cholinergic nerve and nitric oxide synthase effects in rats. Neuroscience letters. 2011 Apr 25;494(2):114-8.

  22. ^ Liu J et al. Chronic Electrical Stimulation at Acupoints Reduces Body Weight and Improves Blood Glucose in Obese Rats via Autonomic Pathway. Obesity surgery. 2015 Jul;25(7):1209-16.

  23. ^ Meng H et al. [Effects of different frequencies of electroacupuncture on blood glucose level in impaired glucose tolerance patients]. Zhen ci yan jiu = Acupuncture research / [Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 2011 Jun;36(3):220-3.

  24. ^ Meng H et al.[Intervention of electroacupuncture for patients with impaired glucose tolerance]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2011 Nov;31(11):971-3.

  25. ^ Shapira MY et al. A sustained, non-insulin related, hypoglycaemic effect of electroacupuncture in diabetic Psammomys obesus. Diabetologia. 2000 Jun;43(6):809-13.

  26. ^ Shen PF, Kong L. [Effects of acupuncture on mood and glucose metabolism in the patient of type 2 diabetes]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2007 Oct;27(10):741-3.

  27. ^ Wang S et al. Transcutaneous vagus nerve stimulation induces tidal melatonin secretion and has an antidiabetic effect in Zucker fatty rats. PloS one. 2015;10(4):e0124195.

  28. ^ Wang Y, Liu ZC, Xu B. [Efficacy analysis on type 2 diabetes mellitus treated with acupuncture in females]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2014 Jan;34(1):21-4.

  29. ^ Wang YD, Liu ZC, Xu B. [Efficacy observation of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2014 Aug;34(8):731-5.

  30. ^ Yang Y, Liu Y. [BO's abdominal acupuncture for obese type-2 diabetes mellitus]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2015 Apr;35(4):330-4.

  31. ^ Yin J et al. Hypoglycemic effects and mechanisms of electroacupuncture on insulin resistance. American journal of physiology Regulatory, integrative and comparative physiology. 2014 Aug 1;307(3):R332-9.

  32. ^ Melchart D et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. 20040113 DCOM- 20040312(0003-9926 (Print)).

  33. ^ Norheim AJ FV. Acupuncture adverse effects are more than occaional case reports: results from questionnaires amon 1135 randomly selected doctors and 197 acupuncturists. Complementary therapies in medicine. 1996;4:8-13.

  34. ^ Seeley EJ, Chambers HF. Diabetic ketoacidosis precipitated by Staphylococcus aureus abscess and bacteremia due to acupuncture: case report and review of the literature. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2006 Jul 1;43(1):e6-8.

  35. ^ Cho YP et al. Retroperitoneal abscess complicated by acupuncture: case report. Journal of Korean medical science. 2003 Oct;18(5):756-7.

  36. ^ Saw A, Kwan MK, Sengupta S. Necrotising fasciitis: a life-threatening complication of acupuncture in a patient with diabetes mellitus. Singapore medical journal. 2004 Apr;45(4):180-2.

  37. ^ Yazawa S et al. Cervical spinal epidural abscess following acupuncture: successful treatment with antibiotics. Internal medicine. 1998 Feb;37(2):161-5.


Nobody has commented on this article

Commenting is only available for registered Diapedia users. Please log in or register first.