The efficacy and potential mechanism of the acupuncture treatment for type 2 diabetes mellitus: A systematic review and meta-analysis of data from animal models

Linsun Lin^1,2Shu Li³Ziyi Guo³Peigang Fang¹Yanchen Feng⁴Congcong Qi⁴Mingyang Wang⁴Lu Xiao^5*Min Chen^1,6*Tao Wang^7*

• ¹Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
• ²Huizhou Health Sciences Polytechnic, Huizhou, China
• ³First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
• ⁴School of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, China
• ⁵Zhuhai Campus, Zunyi Medical University, Zhuhai, China
• ⁶Guangdong Medical University, Zhanjiang, China
• ⁷Encephalopathy center,The Second Affiliation Hospital of Anhui University of Chinese Medicine, Hefei, China

Background: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with limited treatment options. Manual acupuncture and electroacupuncture have been investigated in numerous animal studies for their potential to improve glycemic and lipid profiles, but no comprehensive synthesis exists. This review aims to evaluate the effects of manual acupuncture and electroacupuncture on blood glucose and lipid levels in animal models of T2DM, and to explore potential mechanisms. Methods: A systematic search was conducted in PubMed, Embase, Cochrane, Web of Science, and major Chinese databases from inception to December 2024. Only animal studies employing manual acupuncture or electroacupuncture for T2DM models were included. The methodological quality was assessed using a 10-item CAMARADES checklist. Meta-analyses were performed using STATA 17.0, and subgroup analyses explored the influence of modeling methods, intervention timing, and treatment duration. Results: A total of 14 studies with 274 animals with T2DM were included. The overall quality of the included reports was rated as moderate or higher. Meta-analysis showed that acupuncture significantly reduced blood glucose [Standardized Mean Difference(SMD)= -3.15, 95% Confidence Interval(CI) (-4.18, -2.12,) I-squared(I²)= 85.1%, (P< 0.05)], body weight [SMD = - 3.36, 95%CI (-4.77, -1.95), I²= 84.2%,(P<0.05)], triglycerides [SMD=-2.50, 95% CI (-3.00, -2.01), I²= 0.0%, (P< 0.05)], total cholesterol [SMD = -2.60, 95% CI (-3.55,-1.65,), I²= 74.9%, (P< 0.05)], and low-density lipoprotein [SMD = -3.36, 95%CI (-5.42,-1.95), I²= 86.2%] (P< 0.05)], and no statistically significant difference was observed in high-density lipoprotein [SMD = 0.61, 95% CI (-0.98, 2.19), I² = 92.1%, (P> 0.05)] compared to the control group. These results suggest that acupuncture can effectively improve blood glucose and lipid levels in animal models of T2DM. Conclusion: While this study is limited by the number of included studies, the results indicate that acupuncture can effectively improve blood glucose and lipid levels in animal models of T2DM. Systematic review registration: This research endeavor was duly registered with PROSPERO (ID: CRD 42024520000, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=520000).