Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients

Abstract

Objective:Obesity induces insulin resistance (IR), the key etiologic defect of type 2 diabetes mellitus (T2DM). Therefore, an incidence of obesity-induced diabetes is expected to decrease if obesity is controlled. Although Metformin is currently one of the main treatment options for T2DM in obese patients, resulting in an average of 5% weight loss, adequate weight control in all patients cannot be achieved with Metformin alone. Thus, additional therapies with a weight loss effect, such as acupuncture, may improve the effectiveness of Metformin.Subjective:We designed this randomized clinical trial (RCT) to compare the effects of Metformin monotherapy with that of Metformin and acupuncture combined therapy on weight loss and insulin sensitivity among overweight/obese T2DM patients, to understand whether acupuncture plus Metformin is a better approach than Metformin only on treating diabetes. To understand whether acupuncture can be an insulin sensitizer and, if so, its therapeutic mechanism.Results:Our results show that Metformin and acupuncture combined therapy significantly improves body weight, body mass index (BMI), fasting blood sugar (FBS), fasting insulin (FINS), homeostasis model assessment (HOMA) index, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), leptin, adiponectin, glucagon-like peptide-1 (GLP-1), resistin, serotonin, free fatty acids (FFAs), triglyceride (TG), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc) and ceramides.Conclusions:Consequently, Metformin and acupuncture combined therapy is more effective than Metformin only, proving that acupuncture is an insulin sensitizer and is able to improve insulin sensitivity possibly by reducing body weight and inflammation, while improving lipid metabolism and adipokines. As a result, electro-acupuncture (EA) might be useful in controlling the ongoing epidemics in obesity and T2DM.

Prevalence of and attitudes towards complementary therapy use for weight after breast cancer in Australia: a national survey

“…A recent meta-analysis reported that acupuncture, in particular auricular acupuncture and electro-acupuncture, was more efficacious than sham acupuncture for reducing BMI (MD − 0.47 kg/m 2 ) as well as body fat mass (MD − 0.66 kg), waist circumference (MD − 2.02 cm) and hip circumference (MD − 2.74 cm) but not for reducing body weight overall [20]. Mechanistic studies have suggested multiple responses to acupuncture including appetite suppression [21,22], modulation of leptin and ghrelin [23][24][25] and improved insulin sensitivity [26][27][28][29][30][31]. Further, acupuncture may alleviate co-morbid anxiety symptoms in people with obesity [23,32,33].…”

“…Mechanistic studies have suggested multiple responses to acupuncture including appetite suppression [21,22], modulation of leptin and ghrelin [23][24][25] and improved insulin sensitivity [26][27][28][29][30][31]. Further, acupuncture may alleviate co-morbid anxiety symptoms in people with obesity [23,32,33]. Given that acupuncture is a relatively safe treatment [34][35][36] and may have additional benefits in women with BC including relief of chemotherapyinduced peripheral neuropathy [37], aromatase-inhibitor induced arthralgia [38,39], menopausal symptoms [40] and lymphoedema [41], it may represent a useful adjunctive therapy that can assist women in managing a number of bothersome symptoms and manage weight.…”

Current and future therapies for addressing the effects of inflammation on HDL cholesterol metabolism

“…Electro‐acupuncture shows promise in treating obesity and controlling inflammation. It decreases BMI and the concentrations of IL‐6, TNF‐α, TG and LDL‐C, while increasing the levels of adiponectin and HDL‐C (Firouzjaei et al ., ).…”

Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study

“…In non-PCOS populations, acupuncture, in particular auricular acupuncture and electro-acupuncture, is more efficacious than sham for reducing body mass index (BMI) (mean difference [MD] − 0.47 kg/m 2 ) as well as body fat mass (MD − 0.66 kg), waist circumference (MD − 2.02 cm) and hip circumference (MD − 2.74 cm) [8]. These effects are mediated through multiple responses including appetite suppression [9,10], modulation of leptin and ghrelin [11][12][13], and improved insulin sensitivity [14][15][16][17][18][19]. Further, acupuncture may alleviate comorbid anxiety symptoms in people with obesity [11,20,21].…”

“…These effects are mediated through multiple responses including appetite suppression [9,10], modulation of leptin and ghrelin [11][12][13], and improved insulin sensitivity [14][15][16][17][18][19]. Further, acupuncture may alleviate comorbid anxiety symptoms in people with obesity [11,20,21]. Effects also appear to be sustained after end of treatment [22].…”