Suche
Mein Konto
Relation
Kumar R, Mooventhan A, Manjunath NK. Immediate effect of needling at CV-12 (Zhongwan) acupuncture point on blood glucose levels in patients with type 2 diabetes mellitus: a randomized placebo-controlled pilot study.J Acupuncture Meridian Stud. 2017:19(4):240-244.
Study objective
To examine the effect of needling at CV-12 on random blood glucose (RBG) levels in men with type 2 diabetes (T2D).
Draft
Pilot study, randomized, placebo-controlled trial.
Participant
Forty men with T2D, aged 56.2 ± 11.0 years, who were stable on their medications for the past 3 months were randomly assigned to either the treatment group (n = 20) or the placebo group (n = 20). The 2 groups were similar in age, gender, height, weight and body mass index (BMI). Exclusion criteria included history of T2D complications, needle phobia, and mental illness.
Primary outcome measures
Random blood glucose before and after treatment with a portable ACCU-CHEK Active, Performa Nano device from Roche Diagnostics, Mumbai, India.
intervention
Participants in the treatment group were needled at CV-12 4 cun (4 times the width of a person's thumb at the ankle) above the center of the navel for 30 minutes to a depth of 0.5 cun with a locally manufactured 0.5 cun filiform copper needle 0.38 mm diameter by 13 mm long. Participants in the placebo group were needled for 30 minutes with the same type of needle in 1 cun lateral to CV-12, where there is no known acupuncture point. Manual stimulation, known as bird pecking, where the needle was moved up and down, was performed for 5 minutes in each group.
Key insights
Compared to the control group, RBG was slightly higher in the treatment group at baseline (146.1 vs. 139.15 mg/dl) and slightly lower after acupuncture (133.85 vs. 138.8 mg/dl). The change from baseline in RBG after acupuncture (146.1 vs. 133.85 mg/dL) was significant in the treatment group (P<0.001), but not in the placebo group. There was no significant difference between the two groups in RGB change from baseline after acupuncture.
Practice implications
The impetus for the present study was a 1999 experiment on electroacupuncture in diabetic rats. This study concluded that secretion of endogenous beta-endorphin reduced plasma glucose in an insulin-dependent manner after 30 minutes of electroacupuncture at CV-12 in normal rats and rats with T2D, but not in rats with type 1 diabetes induced by streptozotocin or genetics.1The hypoglycemic effect was abolished by naloxone at a dose sufficient to block opioid receptors and was not supported by glucagon.
In a study published in 2016, Mohanti et al. conducted the first human test of the 1999 rat study on 36 volunteers who received acupuncture for 20 minutes without stimulation at either the CV-12 or the sham point described above.2There was a slight decrease in RBG in the treatment group and a slight increase in RBG in the placebo or sham treatment group, but the results were not statistically significant. The same 3 researchers then conducted and published the present study.
Acupuncture can lower blood sugar if the right point(s) are given in the right person, but the durability of the lowered blood sugar has yet to be proven in a clinical trial.
In a study conducted shortly before the 2016 study by Mohanti et al. was published, researchers performed acupuncture on CV-12, C-10, C-6, C-4, ST-24, TW-5, ST-25, SP-15. and KI-13 three times per week for 3 weeks in 30 obese participants with T2D and compared their responses to 30 similar patients (obese with T2D) taking medication alone.3In the acupuncture group, systolic blood pressure, waist circumference, BMI, fasting blood glucose, 2-hour glucose tolerance test, fasting insulin, total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly reduced (P<0.05). The overall response rate was 93% (28/30) in the acupuncture group and 23% (7/30) in the medication-only group, a significant difference (P<0.01). They did not report whether the effect was lasting.
Other recent studies support the benefits of acupuncture for glucose control in humans. A study published in 2014 included 99 obese women at risk of diabetes.4They were treated with acupuncture, moxibustion, electroacupuncture and combinations of the 3 and had a significant reduction in body weight (P<0.001), BMI (P<0.001), insulin (P<0.01) and insulin resistance index (P<0.01) compared to sham. Thus, there was a significant reduction in their overall risk of developing diabetes.
A research report published in 2010 concluded that there is evidence that acupuncture improves insulin resistance.5Much of the data came from animals, but there was some experimental data on humans. The authors called for studies to determine the feasibility of acupuncture as an effective treatment for diabetes.
CV-12 (Zhongwan) lies on the meridian of the conception vessel.6It is traditionally used for mid-warmer related problems; Digestive problems such as pain, bloating, reflux, vomiting, diarrhea, jaundice; Digestive problems related to a nervous stomach such as anxiety, insomnia, overthinking and worrying; and problems related to the esophagus. CV-12 is also the anterior mu point for the spleen.7Therefore, it is useful for digestive problems related to overthinking and over-worrying. From a chakra perspective, CV-12 is the solar plexus chakra and represents confidence and control over your life.7For patients with needle phobia, CV-12 can be treated with moxibustion.
Summary
In 2014, the World Health Organization estimated that diabetes affected 422 million adults worldwide, or 8.5% of the adult population.8In North America, the current incidence is 1 in 10 adults, with this figure expected to be between 1 in 3 and 1 in 5 by 2050. In the present study, acupuncture significantly reduced RBG in men with diabetes compared to sham acupuncture. It did not reduce RBG to non-diabetic levels and its lasting effect was not evaluated. Acupuncture can lower blood sugar if the right point(s) are given in the right person, but the durability of the lowered blood sugar has yet to be proven in a clinical trial.3-5Clinically, acupuncture may be part of a broader treatment protocol to treat type 2 diabetes, but it has not been proven to be a cure for diabetes.
Study Restrictions
Limitations of the study noted by the authors include its small sample size, inclusion of only male patients, failure to assess long-term effects, and measurement of only RBG (vs. fasting glucose, postprandial glucose, hemoglobin A1c, or insulin). The additional limitations I identified were the lack of information about the medications participants were taking for their T2D, including medication types, dosages and duration of treatment, time between last meal and acupuncture treatment, and mean fasting glucose level for the week prior to trial. Additionally, normal and diabetic glucose levels vary from country to country and the authors have not reported the levels used in India. Although the authors stated that the person who performed the acupuncture was not the one who randomized or analyzed the data, no individual author is identified with any of these roles.