Efficacy and optimal acupoints of auricular acupressure for treating prediabetes: a meta-analysis and data mining

Auricular acupressure has potential in treating prediabetes; however, its effectiveness remains unclear. We aimed to evaluate the effect of auricular acupressure on blood glucose levels in patients with prediabetes and to identify optimal acupoints.

We searched nine public databases for randomized controlled trials published before March 1, 2025, according to pre-established inclusion and exclusion criteria. The risk of bias was assessed using the Risk of Bias 2 tool. RevMan 5.3 was employed to conduct a meta-analysis on glycosylated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and 2-h postprandial blood glucose (2h-PBG) levels, and body mass index (BMI). We used a Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Data mining was used to determine optimal acupoints.

This meta-analysis involved eight studies (694 participants). Compared with lifestyle intervention alone, auricular acupressure combined with lifestyle intervention significantly reduced HbA1c (mean difference [MD] -0.51, 95 % CI -0.84 to -0.18), FBG (MD -0.63, 95 % CI -0.94 to -0.31), and 2h-PBG (MD -0.78, 95 % CI -0.95 to -0.62) levels in patients with prediabetes but no significant effect was observed concerning BMI (MD -0.26, 95 % CI -1.15 to 0.63). The GRADE showed low to very low certainty levels of evidence. Data mining indicated that CO₄, CO₁₀, CO₁₁, CO₁₃, CO₁₄, and CO₁₇ were core acupoints for prediabetes.

Auricular acupressure demonstrates potential as a complementary approach for prediabetes, with CO₄, CO₁₀, CO₁₁, CO₁₃, CO₁₄, and CO₁₇ identified as optimal acupoints. However, due to methodological limitations, these findings require further validation through high-quality evidence.