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Acupuncture/Moxibustion therapy improve diabetes

Acupuncture and moxibustion traditionally have been used in the treatment of diabetes to reduce blood glucose levels and normalize endocrine function. Clinical and experimental studies have demonstrated that acupuncture has a beneficial effect on lowering serum glucose levels.

A typical acupuncture treatment involves needling 4–12 points and allowing the needles to remain in place for ∼10–30 min. Needles may be stimulated manually or by using a small electrical current. In addition, the practitioner may warm the points with moxibustion.

The number of treatments for chronic conditions such as diabetes ranges from 6 to 14 sessions. This may be followed by "tune up" sessions every 2–6 months.6 The cost for the initial session is about $75 –$150, with the follow-up visits costing $65–100 each. Third-party payment for complementary and alternative therapies varies from state to state. Some insurers, such as Blue Cross Blue Shield, cover certain therapies for specific diagnoses only, i.e., acupuncture for pain-related diagnoses. For an additional cost, a few insurance companies offer a separate complementary medicine package that allows the insured to see complementary medicine practitioners at a discounted rate.

Auricular acupuncture (inserting needles into specific points on the ear) may be used alone or in conjunction with body acupuncture. According to TCM, the entire body is represented on the ear. Examination of the ears often reveals surface irregularities, such as superficial capillaries, scars, pitting, pimples, flaking, discoloration, or swelling. Upon probing the auricle of the ear with a rounded, blunt instrument the practitioner may discover tender areas that may correspond to the area of the patient's pain or disturbance. A sample auricular treatment for diabetes might include needling a master point, for example, Shen Men (a good point for almost all disorders), along with the endocrine point, lung point (for thirst), stomach point (for hunger), kidney and bladder points (for frequent urination), and pancreas point (for increasing insulin secretion).

Peripheral neuropathy, one of the most common complications of type 2 diabetes, occurs most often in the distal extremities and typically affects the sensory, motor, and autonomic systems. Acupuncture has been demonstrated to exert a beneficial effect on neuropathic pain.2 The effects of acupuncture, particularly on pain, are mediated in part by the release of endogenous opioids from the spinal cord, brainstem, and hypothalamus. In addition, it has been demonstrated that neurotransmitters, such as serotonin and substance P, are released during acupuncture treatments. Increases in local blood flow and vasodilation and increased levels of cortisol have also been demonstrated.10 A 300% increase in plethysmographic recordings of blood flow has been demonstrated in the digits of limbs stimulated with electroacupuncture.

A recent study of 46 patients with painful peripheral neuropathy evaluated acupuncture analgesia to determine its short- and long-term efficacy. Using TCM acupuncture points, 34 patients (77%) experienced significant improvement in their symptoms. After a follow-up period of 18–52 weeks, 67% were able to stop or significantly reduce their pain medications. Only 8 (24%) required additional acupuncture treatment; (21%) stated that their symptoms had cleared completely.
A randomized, sham-controlled, crossover study of 50 adults with type 2 diabetes evaluated the effectiveness of Percutaneous Nerve Stimulation (PENS) therapy in the treatment of neuropathic pain. PENS is a modern adaptation of acupuncture that uses percutaneously placed acupuncture needles to stimulate peripheral sensory and motor nerves innervating the region of neuropathic pain. The results showed that active PENS treatment improved neuropathic pain symptoms in all patients. In addition to reducing pain, the treatment improved physical activity levels, sense of well-being, and quality of sleep and reduced oral non-opioid analgesic medication requirements.

Because of poor peripheral circulation and slowed healing of skin infections and ulcerations, needling of the lower extremities in diabetic patients should be performed with extreme caution and sterile technique. In general, however, acupuncture appears to be a relatively safe form of treatment. An extensive worldwide literature search identified only 193 adverse events (including relatively minor events, such as bruising and dizziness) over a 15-year period. There have been approximately 86 reported cases of hepatitis B and 1 case of HIV transmission. In all of these cases, nondisposable needles were used.

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