Electroacupuncture Treatment of Insulin Resistance in Diabetes Mellitus

Does Use of Acupuncture Reduce the Risk of Type 2 Diabetes Mellitus in Patients With Rheumatoid Arthritis? Evidence From a Universal Coverage Health Care System

Objectives: Although acupuncture is often advocated for patients with rheumatoid arthritis (RA), its efficacy for type 2 diabetes mellitus (T2DM), a common metabolic disease among RA cohorts, has not yet been established. This retrospective cohort study aimed to determine the association between acupuncture use and the development of T2DM among them.

Methods: Data were collected from 1999 through 2008 for individuals aged 20–70 years in the nationwide insurance database of Taiwan. From them, we extracted 4,941 subjects within newly diagnosed RA and being T2DM free at baseline. A total of 2,237 patients had ever received acupuncture, and 2,704 patients without receiving acupuncture were designated as a control group. All of them were followed to the end of 2013 to identify T2DM incidence. The Cox proportional hazards regression model was utilized to obtain the adjusted hazard ratio (HR) for acupuncture use.

Results: Compared with the RA subjects without use of acupuncture, the incidence of T2DM was lower for those who received acupuncture, with the incidence rates of 24.50 and 18.00 per 1,000 person-years (PYs), respectively. After adjusting for potential confounders, use of acupuncture was significantly related to the lower T2DM risk, with the adjusted HR of 0.73 [95% confidence interval (CI) 0.65–0.86]. Those who used acupuncture for more than five sessions had the greatest benefit in lowering the susceptibility to T2DM.

Conclusion: Adding acupuncture into conventional treatment for RA was found to be related to lower risk of T2DM among RA patients. Further clinical and mechanistic studies are warranted.

Auricular acupuncture induces FNDC5/irisin and attenuates obese inflammation in mice

OBJECTIVE

To investigate whether auricular acupuncture (AA) attenuates bodyweight and obese inflammation through the release of irisin from muscle tissue in mice.

METHODS

Sixty 4-week-old mice were fed a high fat diet (HFD) for 4 weeks. These animals were divided into six groups that remained untreated (HFD) or underwent electrical AA (HFD+EAA), sham EAA (HFD+SEAA), adrenalectomy (HFD+AD), adrenalectomy and EAA (HFD+AD+EAA), or adrenalectomy and injection of recombinant lentivirus expressing fibronectin type III domain-containing protein 5 (rFNDC) (HFD+AD+rFNDC) in the ninth week. The EAA and SEAA were performed at two traditional auricular acupuncture points daily for 4 weeks. An additional 10 mice fed a control diet were included as a normal control (NC) group. At the end of the study, norepinephrine (NE) in the serum, tumour necrosis factor α (TNFα) and interleukin 1β (IL-1β) in the serum and white adipose tissue, irisin in the serum and muscle, uncoupling protein-1 (UCP-1) in the brown adipose tissue (BAT), and FNDC5 in the muscle, were analysed.

RESULTS

The AD+EAA group exhibited better control of bodyweight and inflammation compared with the AD+SEAA and untreated HFD model groups (P<0.05), especially regarding the increased expression of NE, FNDC5, irisin and UCP-1 (P<0.05). After adrenalectomy, mice receiving EAA had less NE, FNDC5, irisin and UCP-1 as well as greater expression of inflammatory cytokines and bodyweight. However, lentiviral overexpression of rFNDC successfully reversed this situation in the AD mice and mimicked the effects of EAA on bodyweight, inflammation and expression of FNDC5, irisin and UCP-1, although it did not impact NE.

CONCLUSIONS

EAA promoted NE release from the adrenal gland leading to further expression of FNDC5, irisin and UCP-1, which contributed to weight management and inflammatory inhibition.

Interaction of Resistance Training, Electroacupuncture and Huang Qi supplementation on skeletal muscle function and GLUT4 protein concentration in rats

Objective

To determine the effects and potential synergy of resistance training (RT), Huang Qi (HQ) herbal supplementation, and electroacupuncture (EA) on skeletal muscle mass, contractile properties, and components of the insulin signalling pathway in healthy Sprague Dawley rats.

Methods

Female Sprague Dawley rats were randomly assigned to one of five groups (n=8 each): control (CON), RT only, RT with EA (RT-EA), RT with HQ (RT-HQ), and RT combined with both EA and HQ (RT-EA-HQ). RT was performed using ladder climbing every other day for 8 weeks. Sparse-wave EA was applied for 15 min/day, 3 times/week for 8 weeks. HQ supplementation was provided via oral gavage daily for 8 weeks.

Results

RT significantly increased the muscle mass of the flexor hallucis longus (FHL) compared to CON. The isometric twitch and tetanic tension of the FHL in the RT-EA, RT-HQ, and RT-EA-HQ groups were significantly higher compared to CON and RT groups. RT-EA treatment (with or without HQ) significantly increased GLUT4 protein concentration but had no impact on Akt-2.

Conclusions

EA appears to be an effective treatment modality for increasing muscle mass and function when combined with RT. RT-EA may also be an effective method for improving glucose tolerance as a result of increases in GLUT4 protein concentration.

Acupuncture attenuates hyperglycaemia and improves ovarian function in female rats subjected to continuous light exposure

OBJECTIVE

Exposure to unnatural light cycles is increasingly associated with obesity and the metabolic syndrome. The purpose of this study was to examine the effects of electroacupuncture (EA) on glucose metabolism and ovarian function in female rats subjected to long-term continuous light exposure.

METHODS

Female Sprague-Dawley rats (n=24) were divided into three experimental groups: an LD group that was maintained under a normal light-dark cycle (healthy control); an LL group that was exposed to continuous light for 21 weeks but remained untreated; and an LL+EA group that received EA at ST36 and SP6 during weeks 17 to 21 of continuous light exposure.

RESULTS

Oestrous cycles of female rats kept in a continuously lit environment for 21 weeks were disordered and polycystic ovarian syndrome (PCOS)-like changes occurred, accompanied by increased fasting blood glucose (6.23±0.33 vs 5.27±0.40 mmol/L in week 17, p=0.015) and reduced fasting levels of serum testosterone (0.07±0.018 vs 0.12±0.058 ng/L, p=0.043) and insulin (0.89±0.20 vs 1.43±0.46 ng/L, p=0.006). After 5 weeks of EA treatment at ST36 and SP6, ovarian cycle disruption was mitigated and blood glucose levels showed a gradual decline (5.18±0.37 vs 5.80±0.55 mmol/L, p=0.017; and 5.73±0.31 vs 6.62±0.13 mmol/L, p=0.004; in the fourth and fifth weeks of EA treatment, respectively). EA also attenuated the reductions otherwise seen in serum insulin and testosterone levels.

CONCLUSION

Prolonged exposure to light can lead to a decline in ovarian and pancreatic function. EA at ST36 and SP6 may reduce abnormally elevated blood glucose levels and improve ovarian and pancreatic hormone levels.

15 hz Electroacupuncture at St36 Improves Insulin Sensitivity and Reduces Free Fatty Acid Levels in Rats with Chronic Dexamethasone-Induced Insulin Resistance

Objective

To evaluate the effect of electroacupuncture (EA) in a rat model of chronic steroid-induced insulin resistance (SIIR).

Methods

An SIIR rat model was created using daily intraperitoneal injections of clinically relevant doses of dexamethasone (1 mg/kg) for 5 days to induce chronic insulin resistance. Thirty-six SIIR rats were randomly divided into the SIIR+EA group (n=18), which received 15 Hz EA at ST36 for 60 min, and the SIIR group (n=18), which remained untreated. Plasma glucose and free fatty acid (FFA) levels were measured in serial blood samples taken without further manipulation (n=6 per group) and during insulin challenge test (ICT, n=6 per group) and intravenous glucose tolerance test (ivGTT, n=6 per group). Insulin receptor substrate (IRS)-1 and glucose transporter (GLUT)-4 were measured using Western blotting and expressed relative to β-actin.

Results

Following EA, area-under-the-curve (AUC) for glucose was reduced (7340±291 vs 10 705±1474 mg/dL/min, p=0.049) and FFA levels significantly lower at 30/60 min in the SIIR+EA versus SIIR groups. Similar effects on glucose AUC were seen during the ICT (5568±275 vs 7136±594 mg/dL/min, p<0.05) and igVTT (11 498±1398 vs 16 652±1217 mg/dL/min, p<0.01). FFA levels were lower at 30 and/or 60 min in SIIR+EA versus SIIR groups (p<0.01). Relative expression of IRS-1 and GLUT4 were significantly increased by EA (p<0.01).

Conclusions

EA decreased the FFA level and increased insulin sensitivity in SIIR rats. Further clinical studies are needed to determine whether EA is an effective alternative treatment for the reduction of insulin resistance in patients requiring chronic use of dexamethasone.

Treatment of insulin resistance by acupuncture: a review of human and animal studies

BACKGROUND

Numerous experimental studies have demonstrated that acupuncture can correct various metabolic disorders such as hyperglycaemia, overweight, hyperphagia, hyperlipidaemia, inflammation, altered activity of the sympathetic nervous system, and insulin signalling defects, all of which contribute to the development of insulin resistance.

OBJECTIVE

To review human and animal studies investigating acupuncture as a treatment for insulin resistance, and to evaluate its potential to increase insulin sensitivity.

METHODS

PubMed was searched for relevant articles published between January 2008 and October 2015. Search terms used were 'acupuncture', 'insulin resistance', 'insulin sensitivity', and 'blood glucose'. Additional secondary sources of information included reference lists from retrieved papers and pertinent papers identified by hand searches of relevant journals not found in the database.

RESULTS

In total, 31 articles were included in this review and comprised studies of the following insulin resistant conditions: obesity (n=9); diabetes mellitus (n=12); polycystic ovarian syndrome (n=7); skeletal muscle atrophy (n=1); ischaemic heart disease (n=1); and fatty liver disease (n=1). Of these articles, seven were human trials and 24 animal experiments. Collectively, the studies suggest that electroacupuncture (EA) at low intensity and low frequency can reduce insulin resistance and increase insulin sensitivity in a range of different insulin-resistant conditions.

CONCLUSIONS

EA, used alone or in combination with other therapies, such as Chinese herbs or diet-exercise interventions, has the potential to be an effective treatment for insulin resistance. Additional controlled clinical studies of acupuncture are needed in subjects with diabetes mellitus, ischaemic heart disease, muscle atrophy, and fatty liver disease.

Significant heat sensitivity increase detected in various types of diabetes mellitus patients by Akabane test for use of management of diabetic patients

In order to assess patterns of heat sensitivity thresholds in patients with diabetes mellitus, the Akabane test was carried out on patients with insulin dependent diabetes mellitus (IDDM) (250 men and 309 women) and patients with noninsulin dependent diabetes mellitus (NIDDM) (158 men and 227 women). For comparison, a group of healthy subjects made up of 116 men and 277 women was also used. As soon as we revealed the influence of factors of pathology with a high significance level and gender and the interaction "gender*pathology", all the results are described separately for groups of men and women and for groups with IDDM and NIDDM. Simple effects of paired comparisons between healthy subjects, IDDM and NIDDM in groups of men and women, as well as comparisons between the profiles of men and women with IDDM and NIDDM showed significant differences between ACs in healthy subjects and those with each type of diabetes. The most significant differences are seen in the AC connected with the digestive system (SP pancreas channel), LR (liver channel), ST (stomach channel), GB (gall bladder channel). Thus, we revealed characteristic pattern of acupuncture channels (AC) lesions inherent to diabetes pathology, i.e. most vulnerable in diabetes ACs, being compromised in dependence from such factors, as type of diabetes, hyper or hypoglycemia, and from gender. The main value of the method lies in the fact that we observe the entire food chain from food ingestion to the utilization of carbohydrates with the opportunity to assess the activity of each organ and its regulatory contribution. On the basis of the body's response, an individual selection of medicines can be made, and by evaluating the individual biorhythms it is possible to determine the optimal time of administration.