Acupuncture in Patients with Diabetic Peripheral Neuropathy-Related Complaints: A Randomized Controlled Clinical Trial

Abstract

Background: Diabetic polyneuropathy (DPN) is a common complication of diabetes, which presents with a loss of sensorimotor function or pain. This study assessed the effectiveness and safety of acupuncture as a treatment for DPN-related complaints. Methods: In this randomized controlled trial, patients with type II diabetes and symptoms of neuropathy in the lower limbs were included. A total of 12 acupuncture treatments were administered over 8 weeks. The waitlist control group received the same acupuncture treatment starting at week 16 (after baseline). Results: A total of 62 patients were randomized (acupuncture group n = 31; control group n = 31). The primary outcome was overall complaints, and it was reduced with a significant difference of 24.7 on a VAS (CI 95% 14.8;34.7, p < 0.001) between both groups in favor of acupuncture. Reductions were recorded for the secondary outcomes VAS pain, neuropathic pain symptom inventory (NPSI), emotional dimensions of pain, SF-12, and diabetic peripheral neuropathic pain impact (DPNPI) after the intervention and at the follow-ups in the acupuncture group. Adverse reactions were minor and transient. Conclusions: Acupuncture leads to a significant and lasting reduction in DPN-related complaints when compared to routine care and is well tolerated, with minor side effects.

Reliability of a novel point of care device for monitoring diabetic peripheral neuropathy

“…The mean velocity (33.1 ± 18.7 m/s) and mean amplitude (3.7 ± 2.1 µV) at baseline were low; an indication of DPN’s presence (Table 1 ). More information about the study population can be found in the publication reporting the primary results of the study 15 .…”

“…The primary outcomes of the ACUDPN study regarding the effects of acupuncture were the DPN related complaints at week 8, measured on a 0–100 mm visual analogue scale, and have been published elsewhere 15 . Gender, age, BMI, and duration of neuropathy were collected at baseline together with other demographical and medical data.…”

A Systematic Guideline by the ASPN Workgroup on the Evidence, Education, and Treatment Algorithm for Painful Diabetic Neuropathy: SWEET

“…If acupuncture is trialed, the semi-standardized acupuncture in diabetic peripheral neuropathy (ACUDPN) treatment protocol with bilateral acupuncture points is recommended. 119 …”

“…Moderate level evidence suggests favorable utilization of acupuncture as an optional treatment for PDN. [117][118][119][120] Numerous prospective clinical studies and RCTs suggest a positive effect with relatively low adverse event rates. 119,[121][122][123][124][125] A singleblinded, placebo-controlled RCT compared acupuncture to sham acupuncture demonstrated low-moderate treatment effect without appreciable side effects, meanwhile another RCT found that pain was improved at week 12 of follow-up but efficacy waned by week 18 when acupuncture was compared to standard of care.…”

Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial

“…In DPN, it has demonstrated a beneficial effect reducing pain and neuropathic symptoms, that upgrade patient’s life quality; and may even induce an improvement in NCS [ 26 – 29 ]. However, it is not yet clearly described whether these interventions may modify other responses, such as molecular or genetic profiles in humans, since there are few randomized controlled trials (RCTs) [ 13 , 27 , 30 , 31 ].…”