Accupuncture for diabetic neuropathy

NewsBot · Aug 2, 2006

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Clinical study on the wrist-ankle acupuncture treatment for 30 cases of diabetic peripheral neuritis.
J Tradit Chin Med. 2006 Mar;26(1):8-12

OBJECTIVE: To study the mechanisms of wrist-ankle acupuncture for prevention and treatment of diabetic peripheral neuritis.

METHODS: Ninety cases of diabetic peripheral neuritis were randomly divided into 3 groups, and treated respectively with wrist-ankle acupuncture, body-acupuncture, and the western routine medical treatment, with 30 cases in each of the groups; and therapeutic effects and laboratory results compared.

RESULTS: It is proved that the therapeutic effects of the wrist-ankle acupuncture group and body acupuncture group were significantly superior to those of the control group, with no significant differences between the former two groups.

CONCLUSION: Wrist-ankle acupuncture has the actions of improving the metabolisms of blood sugar and blood-lipid, lowering down blood viscosity, and restoring the functions of peripheral nerve cells, thus giving definite therapeutic effects for diabetic peripheral neuritis.
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Admin2 · Aug 2, 2006

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Shane Toohey · Feb 22, 2007

Thanks for that Newsbot,

With those interesting results below, I'd like to know more about point selection for the study.

RESULTS: It is proved that the therapeutic effects of the wrist-ankle acupuncture group and body acupuncture group were significantly superior to those of the control group, with no significant differences between the former two groups.

CONCLUSION: Wrist-ankle acupuncture has the actions of improving the metabolisms of blood sugar and blood-lipid, lowering down blood viscosity, and restoring the functions of peripheral nerve cells, thus giving definite therapeutic effects for diabetic peripheral neuritis.
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How can we see the full text? Unfortunately, it's beyond me.
If anyone knows how and even better can put that info up I would be extremely greatfull.

Cheers
Shane

NewsBot · Mar 25, 2014

Role of acupuncture in the management of diabetic painful neuropathy (DPN): a pilot RCT
Adam P Garrow, Mei Xing, Joanne Vere, Barbara Verrall, LiFen Wang, Edward B Jude
Acupunct Med doi:10.1136/acupmed-2013-010495

Aims To examine the role of acupuncture in the treatment of diabetic painful neuropathy (DPN) using a single-blind, placebo-controlled RCT and to collect data that would be required in a future definitive study of the efficacy of acupuncture in DPN.

Methods 45 patients were allocated to receive a 10-week course either of real (53%) or sham (47%) acupuncture. Five standardised acupuncture points on the lower limb of each leg were used in the study: LR3, KI3, SP6, SP10 and ST36. Outcome measures included the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, lower limb pain (Visual Analogue Scale, VAS); Sleep Problem Scale (SPS); Measure Yourself Medical Outcome Profile (MYMOP); 36-item Short Form 36 Health Survey and resting blood pressure (BP).

Results Over the 10-week treatment period, small improvements were seen in VAS −15 (−26 to −3.5), MYMOP −0.89 (−1.4 to −0.3), SPS −2.5 (−4.2 to −0.82) and resting diastolic BP −5.2 (−10.4 to −0.14) in the true acupuncture group. In contrast, there was little change in those receiving sham acupuncture. A moderate treatment effect in favour of active acupuncture was detected in MYMOP scores −0.66 (−0.96 to −0.35) but non-significant effect sizes in LANSS Pain Scale −0.37 (−2.2 to 1.4), resting diastolic BP −0.50 (−3.0 to 1.99) and the SPS −0.51 (−2.2 to 1.16).

Conclusions We have demonstrated the practicality and feasibility of acupuncture as an additional treatment for people with DPN. The treatment was well tolerated with no appreciable side effects. Larger randomised trials are needed to confirm the clinical and cost-effectiveness of acupuncture in the treatment of DPN.
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Craig Payne · Mar 25, 2014

1. They did a within groups analysis rather than a between groups analysis, which is how you are supposed to analyze a RCT
2. Sham group got no treatment, so all improvement in the treatment group could have been due to Hawthorne effect.

Shane Toohey · Mar 25, 2014

On this topic rew the use of Acupuncture techniques in the treatment of symptoms associated with neuropathy.

Yesterday, I received an email which included the quote below. It will have to remain anon as I haven't permission yet to disclose. Obviously, it is just an anecdote, however, I receive them regularly from pods in UK and Australia.

I have had great success with treating a lady who still had neuropathy 7 months after ending chemo and she couldn't get back to her job as she needed to wear boots - after 4 treatments she went back to work.

I treated a lady who had had terribly burning feet for many years and after 4 treatments her feet felt fine.
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My point would be that you otherwise have nothing to offer other than advice about taking precautions about developing secondary conditions etc.

The treatment above would take about 10mins on each occasion, be painless and have extremely low risk of any adverse events.

Perhaps at this stage acupuncture could be accepted as worth trying in the face of a possibility while the researches continue to trial interventions that do not lend themselves to the use of placebos.

Sham acupuncture in its various froms is not really a placebo as it is not inactive and generally tests the specificity of points which is not held as golden in western medical acupuncture as it is in traditional.

Hopefully also, as Craig has pointed out, the apropriate analysis will also be used. The same errors seem to occur in studies related to orthotic therapy.

Cheers
Shane

NewsBot · Oct 11, 2016

Is acupuncture an alternative or adjunctive treatment option for
diabetes-related neuropathic pain? A feasibility study
Christopher Joyce, David Watterson, Caroline McIntosh
The Diabetic Foot Journal, 2016, Vol 19, No 2, pages 75–83 (full text pdf)

Distal symmetric polyneuropathy is a common problem in people with diabetes. Painful neuropathy is challenging to treat. Despite
pharmaceutical management,many patients live with chronic pain. Acupuncture acts by stimulating the nervous system. In Western
medicine, its most widespread application is for pain relief in musculoskeletal pain and chronic pain such as neuralgia and cancer.
Although acupuncture has been cited as a potential therapy for neuropathic pain, the evidence to support its use is lacking. The
authors explore the potential impact acupuncture has on diabetes-related neuropathic pain via a case-series pragmatic study.
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Shane Toohey · Oct 12, 2016

Well done Chris, David and Caroline.
You are always welcome to pass anything by me in your design and methodology. Please dont hesitate regarding me as a resource. Am just on my phone now but will check the full article asap.
Cheers
Shane

(QUOTE="NewsBot, post: 378447, member: 2114"]Is acupuncture an alternative or adjunctive treatment option for
diabetes-related neuropathic pain? A feasibility study
Christopher Joyce, David Watterson, Caroline McIntosh
The Diabetic Foot Journal, 2016, Vol 19, No 2, pages 75–83 (full text pdf)[/QUOTE]

NewsBot · Mar 24, 2019

Acupuncture for the treatment of lower limb diabetic peripheral neuropathy: a systematic review.
Nash J, Armour M, Penkala S
Acupunct Med. 2019 Mar 22:acupmed2018011666.

OBJECTIVE::
To examine evidence for acupuncture interventions in the management of diabetes-related peripheral neuropathy (DPN) symptoms.

METHODS::
Five electronic databases were searched up to June 2017 for studies that included participants with symptoms of DPN, used an acupuncture intervention, and reported before-and-after DPN-related outcome measures. Two reviewers independently performed the data extraction. The level of homogeneity was assessed, and studies were appraised using the Cochrane Risk of Bias tool, the STRICTA guidelines for acupuncture reporting and the NICMAN scale for acupuncture quality.

RESULTS::
Ten studies with 432 participants were included: three randomised controlled trials (RCTs), two pilot RCTs, three uncontrolled clinical trials, one quasi-RCT and one prospective case series. Improvements in DPN pain symptoms were reported by all studies. Heterogeneity of outcome measures prevented a meta-analysis. Variations were found in needle retention time and point selection, as well as total number and frequency of treatments. Common acupuncture point selections were ST36 and SP6. Half of the studies used local point selection. Studies conducted outside China had better acupuncture reporting and quality according to the STRICTA checklist and NICMAN scales, respectively. Risk of bias was high or unclear in the majority of studies for all domains except attrition bias.

CONCLUSIONS::
Acupuncture for DPN appears to improve symptoms. However, the application of acupuncture varies greatly, and the quality of included studies was generally low. Available studies have varying methodologies and different outcome measures. Further, suitably powered studies using appropriate DPN outcome measures are required.
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