Electroacupuncture in glycemic control: Transitioning from clinical controversies to potential basic research

Area of Science:

• Integrative and Complementary Medicine
• Endocrinology
• Neuroscience

Background:

• Type 2 diabetes mellitus (T2DM) is a significant global health concern, with a projected 168 million cases in China by 2050.
• Electroacupuncture (EA) and auricular acupuncture are recognized as safe, accessible, and multi-targeted interventions for glycemic control.
• Existing clinical evidence suggests EA effectively reduces fasting plasma glucose and glycated hemoglobin levels in T2DM patients.

Purpose of the Study:

• To synthesize and critically evaluate existing clinical and animal studies on EA and auricular acupuncture for glycemic control in diabetes.
• To explore the mechanistic insights and translational implications of these acupuncture techniques in diabetes management.
• To identify evidence gaps and highlight the importance of species differences in preclinical research for clinical applicability.

Main Methods:

• Systematic review and critical evaluation of published clinical trials and animal studies.
• Analysis of mechanistic data related to neuro-endocrine-immune pathways, gut microbiota, and insulin signaling.
• Assessment of translational considerations, including species-specific differences between rodents and humans.

Main Results:

• EA targeting trunk and limb acupoints demonstrates significant reductions in fasting plasma glucose and glycated hemoglobin.
• Mechanistic pathways involve modulation of the neuro-endocrine-immune axis, gut microbiota, and insulin signaling.
• Auricular acupuncture may influence glucose homeostasis through vagal nerve stimulation and autonomic modulation.

Conclusions:

• EA and auricular acupuncture represent viable therapeutic strategies for glycemic control in T2DM.
• Understanding species-specific factors is crucial for translating preclinical findings into effective clinical practice.
• Further rigorously designed, large-scale randomized controlled trials are needed to validate efficacy and establish standardized protocols for precision diabetes management.