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Understanding the Purpose of the Review

Type 2 diabetes mellitus (T2DM) affects over half a billion people globally, with rates expected to rise even higher by 2045. Managing blood sugar and insulin resistance typically involves medication and lifestyle changes, but many patients seek complementary treatments with fewer side effects. Acupuncture, an ancient therapy rooted in Traditional Chinese Medicine (TCM), has shown potential benefits for metabolic health.

Researchers from Chengdu University in China conducted a systematic review and meta-analysis—a comprehensive study that combines results from multiple clinical trials—to determine whether acupuncture effectively improves blood sugar control in people with type 2 diabetes.

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Their objective was straightforward: evaluate how acupuncture affects major diabetes indicators, including fasting blood glucose (FBG), glycated hemoglobin (HbA1c), post-meal glucose (2hPG), insulin levels, and insulin resistance (measured by HOMA-IR, the Homeostasis Model Assessment of Insulin Resistance).

What Researchers Looked At

The research team searched four major scientific databases—PubMed, Embase, Web of Science, and the Cochrane Library—up to July 2025. They focused only on randomized controlled trials (RCTs), which are the gold standard in clinical research.

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After screening 1,477 studies, they selected 20 trials involving 1,479 patients (744 receiving acupuncture and 735 in control groups). All participants were diagnosed with type 2 diabetes, and each study compared acupuncture plus standard care to standard care alone or a placebo treatment.

Different acupuncture styles were represented, including both traditional needle acupuncture and electroacupuncture (EA), where mild electrical stimulation is applied through the needles. Treatment duration ranged from several days to 15 weeks.

What the Study Found

The review’s findings were consistent across most studies: acupuncture significantly improved several measures of blood sugar control.

Key Results

1. Fasting Blood Glucose (FBG):
   Acupuncture led to a moderate reduction in fasting blood glucose compared to controls. The standardized mean difference (SMD) was −0.52, meaning blood sugar levels dropped significantly in those receiving acupuncture.
2. Hemoglobin A1c (HbA1c):
   HbA1c measures long-term glucose control. Acupuncture reduced HbA1c by an SMD of −0.76, showing better overall glucose management over time.
3. Two-Hour Postprandial Glucose (2hPG):
   After-meal glucose also improved, with a decrease of −0.69 SMD, indicating acupuncture may help manage spikes in blood sugar following meals.
4. HOMA-IR (Insulin Resistance):
   The reduction in HOMA-IR (−1.72 SMD) suggests acupuncture enhances insulin sensitivity, meaning the body’s cells respond better to insulin.
5. Insulin Levels:
   Interestingly, acupuncture did not significantly change insulin levels (P = 0.06). This suggests that acupuncture’s primary benefit may be improving how the body uses insulin rather than how much insulin is produced.

What These Results Mean

In simpler terms, acupuncture helps the body handle blood sugar more efficiently. Instead of increasing insulin output, acupuncture may make existing insulin work better—a crucial distinction for managing T2DM safely.

Researchers concluded that acupuncture’s positive effects on insulin sensitivity could result from its influence on inflammation, nervous system regulation, and glucose metabolism in the liver and muscles.

In animal studies, electroacupuncture improved glucose uptake in the liver and skeletal muscles, supporting these findings. Human studies also suggest that acupuncture can improve the communication between the nervous system and metabolic organs, leading to better glucose control.

The Bigger Picture

Acupuncture appears to be a safe, low-cost, and non-invasive complementary therapy for people with type 2 diabetes, especially those who struggle with medication side effects or poor treatment response.

While the results are promising, the authors emphasized a few limitations:

• Most trials were conducted in Asia, limiting global generalizability.
• Many studies had small sample sizes and lacked double-blind setups (which are difficult in acupuncture research).
• Long-term effects and standardized acupuncture protocols are still unclear.

Future research should include diverse populations and explore how different acupuncture points, frequencies, and techniques affect blood sugar regulation.

Final Thoughts

This 2025 systematic review strengthens the evidence that acupuncture can effectively support blood sugar control in type 2 diabetes. It lowers fasting and post-meal glucose, improves insulin sensitivity, and reduces HbA1c—but doesn’t significantly alter insulin production.

Acupuncture is not a replacement for conventional medical treatment, but it could serve as a valuable complementary therapy alongside lifestyle and pharmacological management for individuals living with type 2 diabetes.

Reference:
Li N, Xu G, Lin J, et al. Effect of acupuncture for type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Postgraduate Medical Journal. 2025; doi:10.1093/postmj/qgaf132