Acupuncture Therapy for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

Type 2 diabetes mellitus (T2DM) affects the patient's quality of life. Currently, hypoglycemic drugs are mainly used for the standard care for T2DM, but they appear to cause many adverse reactions. As a traditional therapy, acupuncture has been gradually applied to the treatment of T2DM. However, the best acupuncture regimen is still uncertain. Therefore, we evaluated the clinical efficacy of various acupuncture therapies in the treatment of T2DM. Up to December 2nd, 2024, eight databases were searched. The data were analyzed using Stata 15.1 and R 4.2.1 software. The included studies were assessed for bias using the Cochrane risk of bias tool (RoB2.0). A total of 139 randomized controlled trials were included, involving 12,231 patients with T2DM. The results showed that compared with conventional treatment (CT), body acupuncture + CT had the best effect on improving fasting blood glucose (FBG) (MD = -0.84, 95% CI: -1.01, -0.67; SUCRA = 84.44%) and HbA1c (MD = -1.08, 95% CI: -1.42, -0.76; SUCRA = 87.44%); auricular acupuncture + CT had the best effect on improving 2 h postprandial blood glucose (2hBG) (MD = -1.56, 95% CI: -2.05, -1.06: SUCRA = 82.10%), and laser acupuncture + CT had the best effect on improving homeostasis model assessment for insulin resistance (HOMA-IR) (MD = -2.46, 95% CI: -5.85, 0.96; SUCRA = 83.95%), fasting insulin (FINS) (MD = -7.21, 95% CI: -19, 4.54; SUCRA = 82.00%) and overall response rate (RR = 1.45, 95% CI: 0.97, 2.31; SUCRA = 84.00%) Acupuncture can effectively improve diabetes related indicators. Body acupuncture, auricular acupuncture, and laser acupuncture appear to be the most advantageous options for managing T2DM. However, due to the low quality of the included studies, more evidence may be needed to verify the conclusions.